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BY THE SAME AUTHOR 



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SYPHILIS IN THE INNOCENT 

(SYPHILIS INSONTIUM) 



CLINICALLY AND HISTORICALLY CONSIDERED 

WITH A PLAN FOR THE 

LEGAL CONTROL OF THE DISEASE 



BY 

L. DUNCAN BULKLEY, A.M., M.D. 

PHYSICIAN TO THE NEW YORK SKIN AND CANCER HOSPITAL; CONSULTING PHYSICIAN 

TO THE NEW YORK HOSPITAL; LATELY PROFESSOR OF DERMATOLOGY, 

NEW YORK POST-GRADUATE MEDICAL SCHOOL AND HOSPITAL; ETC. 



THE ESSAY TO WHICH THE COLLEGE OF PHYSICIANS OF PHILADELPHIA 

IN 189I, AWARDED THE ALVARENGA PRIZE, FOR THE BEST 

MEMOIR ON ANY MEDICAL SUBJECT 



Ardua molimur; sed nulla nisi ardua virtus." 



NEW YORK 

BAILEY & FAIRCHILD 

29 Park Row 









Copyright, 1894, 

By L. DUNCAN BULKLEY 

Right of Translation Reserved. 

In Exchange 



K Mr 1901 



STUYVESANT PRESS, 

154 & 156 WEST 27TH STREET 

NEW YORK. 



TO 

ALFRED FOURNIER 

AND 

JONATHAN HUTCHINSON 

WHO HAVE DONE MORE TO DEVELOP AND ENCOURAGE THE STUDY OP 

SYPHILIS INSONTIUM 

THAN ANY OTHER LIVING MEN 

THIS VOLUME 

IS 

RESPECTFULLY AND AFFECTIONATELY 

DEDICATED BY 

their friend and admirer 

The Author. 



SYPHILIS IN THE INNOCENT 



INTRODUCTION 



The following essay, the result of ten years' work, is presented 
as a contribution to the study of syphilis. 

Syphilis is not essentially a venereal disease, It has been 
too frequently regarded as being only such, and consequently 
some of its important features have been overlooked. Many able 
writers describe well its clinical history, pathology, and treatment, 
as also its connection with prostitution; but the element of its 
non-venereal character, in many instances, has been relatively 
little considered, and no full presentation of the subject has ever 
been made. In the present essay the attempt is made to consider 
only this single aspect of the malady, namely its innocent occur- 
rence and the modes of infection whereby it is innocently 
acquired, by means wholly unconnected with the venereal act. 

Nor is the entire subject of innocent syphilis here com- 
passed, for that would lead us much farther than proposed, and 
its consideration might well occupy many volumes such as this. 
As will be seen later, this would include hereditary syphilis, and 
that acquired in the ordinary relations of married life; subjects 



Xll INTR OD UCTION 

which have been so fully treated by others that they are omitted 
from the present work. 

i But even this single branch of the subject is of such vast 
extent that I can hardly hope that the entire ground has been 
covered, or that all of the observations which have been made 
have been here utilized ; and yet it is not too much to claim 
that this is the most complete monograph on this subject which 
has yet appeared. 

In the preparation of the work, writings in a dozen languages 
have been consulted directly, in addition to certain quotations or 
translations which may have occurred in print from other sources. 

Clinical records, more or less complete, are given of one hun- 
dred and sixteen original personal cases of extra-genital chan- 
cres, a greater number than has ever before been reported by 
any observer in the United States. 

For the first time there is here offered a classification of the 
modes or methods of infection in syphilis insontium, describing over 
one hundred categories of transmission. These are grouped under 
three main heads, according as syphilis occurs, ist, In connection 
with household and industrial life; or 2d, In the care of children; 
or 3d, In professional pursuits. This classification is based on the 
clinical observations which have been here gathered from litera- 
ture, and has been educed synthetically as the work of collection 
of the data proceeded. 

A Table is given of over 7,000 cases of chancre reported 
by various observers in venereal clinics, to show the relative pro- 
portion of extra-genital to genital chancres. Another Table 
has been prepared exhibiting the location of over 9,000 extra- 
genital chancres, which have been collected from the items given 
in the Analytical Bibliography. 



INTRODUCTION Xlll 

Still another Table, as complete as possible, gives the epi- 
demics of syphilis which have occurred from the year 1577 to 
the present time; this contains data relating to over 100 epi- 
demics, great and small, affecting over 3,000 victims, in addition 
to the many instances where no definite statistics were given. 

Accounts are also given of the various endemic diseases which, 
occurring in different times and countries, and under more than 
twenty different names, are now recognized as varied manifesta- 
tions of syphilis. 

I have made no attempt to include in the text reference to all 
who have reported cases or written upon the subject in hand, 
only the more interesting or striking cases or matter were selected; 
and the Synopsis of Facts and Literature, at the end of the 
work, as well as also the Analytical Bibliography, should be 
taken in connection with the text, in order to understand the 
subject completely. 

The Analytical Bibliography contains references to over one 
thousand reporters of cases, several hundred of whom are referred 
to or quoted in the text. It has been my aim to make this 
Bibliography complete to January 1, 1893. The originals have 
been consulted wherever possible, but a certain number of refer- 
ences are taken at second hand, in which instance the second 
references are given in brackets; these latter are also often in- 
serted even when the original has been consulted, as they may 
prove of value to those desiring fuller information than is here 
given, and who may not be able to consult the original. 

I have to express my warmest thanks and acknowledgements 
for most valuable aid in the preparation of this work to my friends, 
Dr. Edward Preble, of Cleveland, Ohio, Drs. H. H. Whitehouse, 
Thomas L. Stedman, B. Lapowski, and Titus M. Coan, of New 



XIV INTRODUCTION 

York, and Dr. Valerius Idelson, of Berne, Switzerland; without 
their active co-operation this essay would have been less complete 
than it is. 

Recognizing the limitations of the work, and the necessarily 
incomplete manner in which some great questions have been con- 
sidered, the writer hopes that his labors may not be without 
interest to others, and may contribute to a more perfect knowl- 
edge of syphilis ; it is thus hoped that it may aid in the advance 
of medical science and the good of mankind, and may assist in 
helping to check the innocent spread of the disease. 

4 East Thirty-seventh Street, New York, 
January i, 1894. 



TABLE OF CONTENTS 



CHAPTER I. oA „„ 

PAGE 

General Considerations. — Syphilis as a Disease. — Definition, An- 
tiquity, Modes of Diffusion, Present Distribution of Syphilis. . 1-12 



CHAPTER II. 

Forms of Syphilis. — I. As a Venereal Disease (Syphilis Pravorum). 
II. As a Non-Venereal Disease (Syphilis Innocentium or Insontium). — 
Divisions of Non-Venereal Syphilis: i. Syphilis Ingenita; 2. 
Syphilis e Coitu Legitima; 3. Syphilis sine Coitu .... 13-20 

CHAPTER III. 

Syphilis Insontium sine Coitu. — Clinical Considerations. — Modes of 
Infection: Immediate Contagion, Mediate Contagion. — Location 
of Primary Lesions 21-34 

CHAPTER IV. 

Clinical Considerations.— Personal Cases. — Chancres of the Lip, 
Tonsil, Finger, Breast, Tongue, Cheek, Eyelid, Chin, Hand, 
Nose, Ear, Temple, Neck, Forearm, and Sacral Region . . 35-106 

CHAPTER V. 

Demography of Syphilis. — Causes and Methods of the Spread of 
Syphilis in the Past and Present. A. Syphilis Pandemica (In- 
cluding Syphilis Epidemica and Endemica). B. Syphilis Sporadica 
(Including Syphilis Economica, Brephotrophica, and Technica). 107-112 

CHAPTER VI. 
A. Syphilis Pandemica. — I. Syphilis Epidemica; II. Syphilis Endemica 113-141 



xvi . TABLE OF CONTENTS 

CHAPTER VII. 

B. Syphilis Sporadica. — I. Syphilis Economica: i. Syphilis Propa- 
gated in Domestic and Social Relations; 2. Syphilis Communi- 
cated in Industrial Relations , . 142-157 

CHAPTER VIII. 

B. Syphilis Sporadica (Continued). — II. Syphilis Brephotrophica: 
1. Syphilis Communicated in Connection with Nutrition of In- 
fants; 2. Syphilis Propagated by Attendance upon Infants 158-171 

CHAPTER IX. 

B. Syphilis Sporadica (Continued). — III. Syphilis Technica: i. Opera- 
tor the Victim; 2. Operator the Syphhlifer; 3. Operator the 
Medium , 172-195 

CHAPTER X. 

Prophylaxis: Hygienic and Medico-Legal Considerations. — Plan for 
the Legal Control of Syphilis 196-207 

Synopsis of Facts and Literature Relating to Syphilis Insontium 209-240 

Analytical Bibliography of Syphilis Insontium' 241-3S6 

Index . . , 387-398 



SYPHILIS INSONTIUM 



CHAPTER L 



GENERAL CONSIDERATIONS. — SYPHILIS AS A DISEASE. — DEFINITION, 

ANTIQUITY, MODES OF DIFFUSION, PRESENT 

DISTRIBUTION OF SYPHILIS. 

Syphilis is one of the most important diseases affecting the 
human race, and its study has occupied the thought and activity 
of observers almost more than that of any other one malady, 
while its literature probably exceeds that relating to any other 
single disease. The advances which have been made in the 
knowledge of the course, manifestations, and results of syphilis 
during the past fifty years are very great, and have done much 
to limit its extension by innocent means, and have also served 
to rob it largely of the terror with which it has been surrounded 
in earlier times. Much, however, undoubtedly remains still to 
be learned in regard to this protean malady, whose entrance into 
the system is often so unexpected and whose earliest symptoms 
are sometimes so trivial, and yet whose later results are fre- 
quently so disastrous and far-reaching, possibly even to many 
generations. 

No attempt will here be made to consider syphilis in all of 
its many interesting and important aspects ; the subject is one 
which presents an ever-widening field of study, while research 
into the literature relating to syphilis opens lines of investiga- 
tion, and material for thought, almost boundless. The object 
of the present work is rather to develop the subject of syphilis 
2 



2 SYPHILIS INSONTIUM 

of non-venereal origin, which, as will be seen later, offers points 
well worthy of careful consideration, both from a scientific and 
a practical aspect, as well as from a hygenic, sanitary, and medico- 
legal point of view. 

Syphilis is one disease, however it is acquired ; one poison 
or virus, whatever it may be, whether a micro-organism or an 
animal product, is always present in every case, arid is in some 
manner always transmitted to the person who acquires the dis- 
ease. The modes and methods by which syphilis has been 
acquired, other than in sexual congress, are very numerous and 
varied, as will appear later ; but in every instance it is one 
and the same disease, which may be again communicated, under 
proper circumstances, to any number of individuals. 

Syphilis may be defined as a contagious disease, chronic in char- 
acter, due to the entrance of a specific virus into the system, which is 
capable of further propagation and transmission, both by inheritance and by 
inoculation with the blood and morbid secretions from the affected indi- 
vidual. In the course of the disease a variety of inflammatory and 
neoplastic lesions are produced, in a more or less regular and definite 
order, which may affect every organ and structure of the body. As a 
rule syphilis can be acquired but once during a life-time. 

The antiquity of syphilis has been the subject of much research 
and discussion by able writers, and very divergent views have 
been entertained in regard to the date when it first existed as a 
disease, a matter which is somewhat foreign to our present sub- 
ject. It is, however, accepted by all that in the years 1494 and 
1495 there occurred a sudden and very great spread of syphilis in 
certain countries of Europe, at a date closely following the 
discovery of America, and about the time of the invasion of Italy 
by Charles VIII. of. France; and it is further agreed by all that 
our knowledge of syphilis, as a disease, dates almost wholly from 
that epoch. 

Researches of modern times have, on the other hand, demon- 
strated beyond a doubt that syphilis has existed from the earliest 
periods of which we have any records ; able scholars have recog- 
nized many allusions to the disease in the Bible, and according to 
Dabry, 1 perfect descriptions of chancres and of syphilitic lesions 
of the skin and mucous membrane are found in Chinese literature, 
some of it relating to more than 2000 years B. C. A recently 

1 Dabry. La medecine chez les Chinois, Paris, 1863, p. 251. 



A NTIQ UITY OF S YPHIL TS $ 

discovered Japanese book, dating back to the beginning of the 
ninth century, is said by Scheube 1 to contain a full description of 
syphilis in all its forms, and to recognize their constitutional 
nature, and connection with local sores. 

Whether or not syphilis existed in Europe previous to the date 
mentioned of its outburst in Italy, at the close of the fifteenth 
century, is still questioned by some, but recent writers have shown 
beyond a peradventure 2 that syphilis was known throughout 
Europe at a very much earlier period, as a constitutional disease, 
which was acquired through impure venereal contact. There is 
also evidence, from bones recently disinterred in France, 3 that the 
disease had occurred there occasionally before that date, and 
possibly even in very ancient or pre-historic times. Bones thought 
to be unquestionably syphilitic have likewise been discovered by 
Dr. Jones, 4 of New Orleans, and others in the indian graves of the 
United States, which are also apparently of equal or greater 
antiquity ; it must be stated, however, that some 6 have doubted 
both the syphilitic character of the bone lesions, and the pre-; 
historic origin of the same. 

How or when syphilis originated is a matter utterly beyond 
human discovery, nor do we know much more of the dates and 
methods of its extension over the world, except in reference to 
certain countries within the last two or three hundred years. 
From what has been observed within this period, however, we 
may judge more or less correctly of the modes by which it has 
been spread in previous times, for in many instances we have very 
accurate accounts of the manner in which even large communities 
have been infected, as will appear more fully later. 

Syphilis is everywhere seen to be a disease more especially 
belonging to communities, and flourishing most luxuriantly where- 
ever there is a crowding or massing together of individuals, for 
the reason that thus the elements for its propagation become more 
concentrated, and opportunities for its communication more 
common ; syphilis is, therefore, most abundantly met with in cities, 
and its frequency is commonly seen to diminish in a pretty direct 

1 Scheube. Virchow's Arch., 1883 XCI. p. 448 (Quoted by Hirsch, Handb. der hist.,geogr. Path. 
Stuttgart, 1883, 2te Abtheil p. 467.) 

2 Hirsch. Handbuch der histor.-geograph. Pathologie, Stuttgart, 1883, 2te Abtheil p. 42. 

3 Jlllien. Traite pratique des Maladies Veneriennes, 2d ed., Paris, 1886, p. 454. 

4 Jones. New Orleans Med. and Surg. Journal, June, 1878, pp. 926-941. 

5 Hyde. A contribution to the Study of Pre-Columbian Syphilis in America. Amer. Jour. Medo 
Sciences, August, 1891. 



4 SYPHILIS INSQNTIUM 

ratio to the suburban or rural character of the people. There are 
many exceptions to this rule, however, as will appear later in the 
chapter on epidemic and endemic syphilis; it will there be seen 
that the disease has at times spread with great rapidity in country 
towns and among communities where there were none of the 
causes operating to which its extension is generally attributed ; it 
is ; still thus increasing among the peasantry of certain districts, as 
in Russia, where gross ignorance prevails. 

Prostitution undoubtedly stands foremost as a cause of syphilis, 
and, far outweighs all other causes together, certainly at the 
present time. In addition to the ordinary spread of the disease in 
towns and cities by this means, it is likewise propagated very 
largely by sailors and soldiers, and consequently is particularly 
frequent in all seaport and garrison towns. Returning to their 
homes men of this class are also apt to carry infection with them, 
even to distant parts, and to communicate the disease to their 
families, and others, in thoroughly innocent manners; thus 
syphilis will often gain a foothold, and may even be widely 
distributed in rural districts. 

Wars and migrations, as also market-gatherings, fairs, and 
festivals are frequently, in like manner, the means of spreading 
syphilis, from the license attending them; statistics abundantly 
demonstrate this, and it has been recently very clearly shown by 
MAURiAc/in regard to Paris. Great public works, as the building 
of the dikes in Holland, 2 have likewise contributed largely to the 
extension of the disease, through the licentiousness attending the 
gathering of large bodies of men, unattended with their wives. 

Even in recent times, especially in Russia, syphilis has been 
spread by means of pilgrimages, which often occupy weeks or 
months, and are attended with much laxity of morals; also the 
intimate mingling of the pilgrims, in an innocent manner, on these 
occasions serves to propagate the malady. 

In later years, syphilis has spread along the lines of commercial 
intercourse, such as railways, rivers and canals ; and manufacturing 
centres are often seen to afford the opportunity for the diffusion 
of the disease. 

With the increase of syphilis by venereal excess there have 
always occurred necessarily a not inconsiderable number of cases 

1 Maukiac. Le9ons sur les Maladies Veneriennes, Paris, 1883, pp. 182-226. 
* Struve. Ueber die aussatzartige Krankheit Holsteins, Altona, 1820, p. 26. 



SYPHILIS IN EUROPE 5 

where the disease was acquired innocently, the ratio of the one 
class of cases to the other varying considerably in different locali- 
ties and under different circumstances. In former times, before 
the nature of the malady was well known and the dangers of 
contagion understood, this mode of infection was really very 
common, and syphilis was repeatedly spread as an epidemic among 
certain communities; many descriptions of such visitations have 
been written and some of them will be considered fully in another 
chapter. 

From one cause and another, therefore, syphilis has gradually 
become very widely distributed over the earth, and there is now 
hardly any portion of the known world where it has not been 
recognized, modified in certain localities by peculiarities of race, or 
climate, or soil. The subject has been very fully studied by 
Hirsch, 1 Lagneau, 2 Lancereaux, 3 Rey, 4 Buret, 6 and others 6 and 
brief reference may be made to the results of their work in con- 
nection with this subject. 

EUROPE. 

i. Iceland. Syphilis does not flourish here, for although re- 
peatedly introduced from other countries it has very quickly died 
out. Thus, in 1756 it found its way to the weavers and spinners 
of Reykjavik; 7 but in 1763 it was a rare disease, and in 1774 it was 
extinct. In one or two other localities it has been similarly intro- 
duced and has in like manner died away. 

2. Norway and Sweden. Introduced on the coast of Norway in 
1709 or 1 7 10, syphilis soon made great ravages, at first under the 
name of Radesyge, and has since extended very generally, though 
in a much milder form than previous^. 

3. Russia. According to Leinenberg, 8 of Odessa, Russia has a 
peculiar though unenviable position among European states in 
regard to syphilis, where it is so common among the peasantry 
that it has long been regarded a scourge in the widest sense 
of the word ; in some villages at least one-quarter of the inhabi- 
tants are infected. 

1 Hirsch. Handb. der histor.-geograph. Pathologie, 2te. Abtheil, Stuttgart, 1883. 

2 Lagneau. Recherches comparatives sur les maladies veneriennes, etc., Paris, 1867. 

3 Lancereaux. A Treatise on Syphilis, etc. Sydenham Society Ed. London, 1868, I; p. 45. 

* Rey. De la syphilis suivant les races et les climats. Ann. de Derm, et de Syphilig., 1880, p. 6^2. 

5 Buret. La Syphilis aujourd'hui et chez les Anciens. Paris, 1890. 

6 Mauriac. Lf 90ns sur les mal. vener, Paris, 1883, p. 236; * * * Jullien. Traite pratique sur les 
mal. vener, Paris, 1886, p. 472, etc. 

1 Iceland, by P. A. Schleisner, M. D., Brit, and For. Medico-Chir. Rev., Vol. 5, 1850, p. 459. 
8 Leinenberg. Die Syphilis in Russland, Munchen, 1887, p. 2. 



6 SYPHILIS INSONTIUM 

4. Turkey. Syphilis is very frequent in different sections of 
Turkey, known as Frenga in Servia, Spirocolon in Greece, and Boala 
lumeasca or le mal qui court le monde in Roumania, ' ' where it has 
made great ravages in all classes of society. Its different forms 
are met with among almost all the inhabitants, young and old, 
infants and adults, both in the cities and in the country districts." 1 

5. Italy. Since the memorable outbreak of syphilis in Italy at 
the close of the fifteenth century, the disease has been present 
almost everywhere in considerable strength, at times appearing as 
an epidemic, as at Capistrello and elsewliere, or remaining 
endemically as in the case of the Scherljevo, Facaldina, and Mal di 
Breno, as will be mentioned in the chapter on Pandemic Syphilis. 

6. Spain and Portugal. Syphilis is very common and severe in 
these countries especially in the southern part of Spain. In 
Portugal, Ferguson 2 in 181 2 stated that a large share of the popu- 
lation had become infected, through long neglect; by recent 
reports from the army records we learn that there are 182 
syphilitics in each 1000 soldiers. 

7. France. While syphilis appears to be increasing in the large 
cities of France, and, according to Mauriac, 3 from 5000 to 8,000 
persons acquire syphilis in Paris each year, it is relatively in- 
frequent in the villages and country districts; although a number 
of epidemics of syphilis insontium have occurred in villages, in times 
past, as will be noted later. Marseilles seems to be the city where 
syphilis abounds to the greatest degree at the present time. 

8. Belgium and Holland. After the great outbreak of syphilis of 
the fifteenth century, which extended to the lowlands, a ' ' recru- 
descence " of the disease was described by Everardus, 4 Blancaard 
and others, occurring in the island of Seeland, about the middle of 
the seventeenth century, from the custom of drawing breasts. 
From this and similar episodes, it is evident that syphilis insontium 
was not unknown in the Netherlands. Owing, however, to the 
prophylatic measures in force by the government in Belgium, 5 
syphilis has become very much less frequent, so that the army 
reports show the smallest proportion of all the European states. 

1 Rey. La Syphilis suivant les races, etc. Annales de Derm, et de Syph., 1880. 

2 Ferguson. Cited by Henry Lee, Lectures on Syphilitic and Vaccino-syphilitic inoculations, 
London, 1863, p. 214. 

8 Mauriac. Cited by Jullien. Traite pratique des maladies veneriennes, 2d ed., Paris, 1S86, p. 477. 
4 Die Neu-erweckte Sauger-Seuche in ihrer Vergleichung mit der Frantzosen oder Indianischen- 
Krankheit, etc. (German transl. of Blancaard, Sylvius, Sydenham, Wyer, and Everardus, Leipzig, 16S9). 
* Lagneau. Recherches comparatives sur les mal. vener., etc., Paris, 1867, p. 13. 



S YPHILIS IN E UR OPE 7 

9. Denmark. In the Jutish peninsula, an epidemic form of 
syphilis was recognized and described by Lillie in 1777, and by 
Van Deurs in 1835, and since that time has been very prevalent in 
the maritime cities. In Schleswig-Holstein, on the western coast, 
a separate epidemic arose at about the same time, known as the 
Marsh- disease, and was confounded in part with leprosy. It was 
probably brought thither by the dike-builders. 

10. Prussia. Endemics along the Baltic coast, especially in 
Lithuania, occurred at the time of the other endemics, and the 
disease is said later to have nearly decimated some districts. 
Syphilis insoniium seems to prevail in Silesia, from the number and 
variety of cases reported from Breslau. 

11. Middle German States. Bavaria and Wurtemberg were 
favored with numerous large epidemics from cupping, etc., about 
a century after the first European outbreak of syphilis. The 
disease has been prevalent there since that time, but was held in 
check by sanitary precautions, until, by a modification of the 
police restrictions, in 1861, the number of those infected rapidly 
doubled in Munich. 

12. Switzerland. Like the preceding sections of Europe, Switer- 
land has been the seat of numerous outbursts of the disease as is 
witnessed by frequent legislative enactments intended to check its 
diffusion ; at present syphilis is said to be less common here than 
in many other European states. 

13. Austro- Hungary. The eastern part of the empire was the 
seat of the first renaissance of syphilis, in 1577, in Moravia, in the 
shape of the Maladie de Brunn, from cupping. The eastern and 
southern portions are still more or less scourged by the endemics 
common to Russia on the one hand, and the Adriatic coast on 
the other. 

14. Great Britain and Ireland. Syphilis first appeared here in 
1496, and has steadily increased up to the present time. In 
the Scotch Highlands it has been known as Sibbens or Yaws, since 
the year 1690. It now prevails widely in the great cities and 
ports, favored by the neglect of all restrictions on prostitution. 
Dr. Holland, 1 in reviewing the literature of prostitution in 1854, 
and the measures for the control of syphilis in several European 
cities and states, estimates that in the United Kingdom there were 
at least a million and a half persons infected with syphilis during 

l Holland. British and Foreign Medico-chirurgical Review, Vol. XIII, 1854, p. 357. 



8 SYPHILIS INSONTIUM 

each year. There can be no doubt that the disease was greatly 
diminished during the operation of the ' ' Contagious Diseases 
Acts," from 1864 to 1881, as shown by official reports from the 
towns where they were enforced ; 1 since their repeal it is on the 
increase in seaports and large cities. 

ASIA. 

1. Siberia. Syphilis is frequent and severe among the abo- 
rigines, and especially so in Kamtchatka. A special endemic has 
been described as the Berreshoff Disease. 

2. Japan. The disease is reported as exceedingly frequent in 
Japan, under the name of Feu de volupte' and Mai portugias. It has 
been stated by Eldridge 2 that it is very exceptional to meet a 
male Japanese who will not acknowledge that at some time he has 
suffered from syphilis. In 1869, an investigation of the prostitutes 
in Yokohama revealed 33 out of 100 affected with constitutional 
syphilis, and generally with grave forms of the disease. Well 
organized sanitary police measures have, however, since that time 
greatly diminished the dangers from this disease. 

3. China. Both the coast and interior of China are said to be 
saturated with syphilis, which is relatively mild among the natives, 
but severe among the unacclimated. The reason for the compara- 
tively benign character of the disease among the Chinese is 
undoubtedly found in the protection afforded by previous race 
infection, the disease having existed here from the remotest period. 
In 1870, at the general hospital at Shanghai, where the ships of 
all nations send their sailors, syphilis formed 19 per cent, of all 
cases, and in Hong Kong, 16 per cent, of all cases were of syphilis, 
while in the French hospital at Tien-tsin in 1861, almost 30 per 
cent, of all cases were of this disease. 

4. Farther India. Some interior tribes of aborigines are said 
to be exempt from syphilis, but on the coast, certainly among the 
Europeans, if not among the natives, syphilis is very common and 
grave. At Singapore sanitary restrictions have caused the disease, 
which was previously very frequent in this seaport, to diminish to 
a very great degree. 

5. Malay Archipelago. In some of these islands the disease is 

extremely common and severe, both among natives and whites. 

• 

1 History and working of the Contagious Diseases Acts, by H. C Sluggett, Tottenham, 1882. 

2 Eldridge. Pacific Med. & Surg. Journal, Oct. 1881. N. Y. Med. Journal, March, 1882, p. 335. 



S YPHILIS IN ASIA AND A FRICA 9 

The special features in this section of the world seem to be the 
severity of the general outbreak, and the prevalence of hereditary- 
taint. 

6. India (Hindostan). There is evidence here, as in China, of 
the great antiquity of the disease. It seems, however, to be 
diminishing in frequency in late years, so that while the average 
number of those infected with venereal diseases in the army in 
1859 was 267 per 1000, in 1873 it was but 167 per 1000. 

7. Arabia. Syphilis is said to be rare here, except along 
caravan routes, and at the seaports. 

8. Western Asia. The inhabitants of the table-land surface 
comprising Afghanistan, Beloochistan, etc. , are said to have syph- 
ilis extensively, but in a mild form. The exceptions to the latter 
are stated to be Armenia, where it is especially grave, and Persia, 
where syphilis is not very widely spread, and is said to present 
a remarkably benign character. 

9. Asia Minor. Along the entire litoral, syphilis is prevalent 
and grave. The sedentary Mohammedans, coast-dwellers, etc., 
suffer far more than the nomads and inland-inhabitants. It is 
reported that it has affected the mountain districts of Syria only 
since the passage of the armies of Ibrahim Pacha. 

AFRICA. 

1. Morocco. " Syphilis is spread here among all classes; one 
cannot go far without meeting those exhibiting the marks of 
small-pox or syphilis. " - 

2. Algiers. A special form of syphilis is that affecting the 
Algerine Arabs, known as the Lfyre Kabyle; in 1868, out of 
1000 patients in the hospitals of Algiers 113 were syphilitic. 
The disease is usually neglected and presents very grave 
conditions. 

3. Tunis. Syphilis also prevails here very extensively; "those 
who do not have it are the rare exception;" 1 the notion of any 
venereal or scandalous element connected with the disease is, 
however, not present. It is, moreover, benign in character. 

4. Egypt. ' ' The disease here attains an extraordinary fre- 
quency, and is met with in all forms ; the primary sores are quite 
as abundant as the secondary and tertiary lesions. From Alexan- 

l Rubatel and Tirant. Lyon Med. 1874, II. p. 249 (Hirsch Handb. der hist-geograph. Path. Stutt- 
gart, 1883, 2 te Abthcil p. 54.) 



io SYPHILIS INSONTIUM 

dria to the second cataracts it is very wide-spread, and even to 
Kartoum, where there have occurred true epidemics of the 
malady." 

5. Nubia. Although syphilis is prevalent in Nubia there seems 
to be more effort towards prompt, systematic treatment of the 
disease by the natives, and it is relatively mild. 

6. Abyssinia. Syphilis is very wide-spread here 1 and Dr. 
Blanc estimates that nine-tenths of the Abyssinians are affected 
in different degrees ; it is here mainly known as the Mai or Lepra 
Kabyle. According to Hirsch, syphilis was not introduced into 
the deeper valleys until the present century, and the inhabitants 
of Gallas have been free till within a few years. 

7. Eastern Africa. In Madagascar some tribes seem to present 
a singular immunity from syphilis, even in spite of constant 
exposure, while others are much affected, even the children. In 
Zanzibar and the neighboring mainland syphilis is said to be so 
common that half of the patients applying for treatment are 
affected with some form of the disease. 2 

8. South Africa. The natives here are believed to be contami- 
nated in proportion to dealings with Europeans. 

9. Western Africa. In Senegal, Sierra Leone, etc., syphilis 
proper is very common and grave on the lit oral. Among the 
natives, however, in past centuries and at present, there is the 
widely spread endemic of Yaws and Plan, and, while the pure 
African exhibits a certain immunity from venereal syphilis, he has 
a predilection for the disease yaws, to which the Caucasian is 
refractory. 

10. Central Africa. As far as is known, the inhabitants are 
free from syphilis in proportion as they are of unmixed blood; 
those of mixed blood suffer in proportion to their admixture of 
European blood. Livingstone states that syphilis seems incapable 
of permanence in any form in persons of pure African blood any- 
where in the center of the country.' 

11. Sahara, Soudan, etc. Conflicting reports are given from the 
oases and isolated regions explored. Some report lesions par- 
taking of the nature of the Mai Kabyle of Abyssinia; others 
report a mild, wide-spread epidemic prevalence of ordinary 
syphilis. 

1 Rev. Annales de Dermatologie et de Syphiligraphie, 1880, p. 688. 

2 Hirsch loc cit p. 53. 



S YPHILIS IN A M ERIC A 1 1 



NORTH AMERICA. 



i. British America. About a century ago, the litoral of the 
great lake chain was the seat of a grand epidemo-endemic of 
syphilis (Maladie de la Baie de St. Paul), in which Indians and 
whites, of all ages, suffered severely. In 1874 it was reported by 
Maurin that the cases of syphilis were numerous and grave among 
the Indian population. 

2. Greenland. Syphilis has never been able to establish itself 
here ; in Labrador the Mai des Ottawas is now known to be only 
secondary syphilis resembling the Norwegian radesyge. 

3. Alaska. The natives here suffer in like manner with the 
Kamtchatkans. At Sitka syphilis is not rarely seen, but its 
character is not severe and it yields easily to treatment. 

4. United States. Syphilis, as now spread throughout the 
States, is a result of infection during comparatively recent years, 
following in the line of commercial and industrial extension; it 
now prevails largely in all the great cities, unrestricted by any 
sanitary regulations, but is comparatively rare in rural districts. 
There are evidences found by Dr. Jones of New Orleans, as already 
mentioned, in exhumed bones, that the disease existed here many 
centuries ago, but it is questionable if the disease as it now exists 
is in any way traceable to this primeval source. 

5. Mexico, The Antilles, etc. Among the highly complex popu- 
lace of Mexico syphilis is so common that its venereal nature is 
ignored, and as a rule the malady is extremely grave. Some 
tribes of pure blood natives are yet free from disease. In the 
West Indies, the conspicuous form is Yaws, imported by and 
prevalent among the negroes. In Honduras an affection exists 
known as Granos, which appears to be syphilis. 

SOUTH AMERICA. 

Nearly the whole domain of the Spanish and Portugese con- 
quest is the seat of widely spread and severe syphilis. The extra- 
ordinary spread of the disease, wherever introduced by the whites, 
may be due to the serf -like character of the aborigines and their 
rapid amalgamation with the colonists. In Brazil it is stated that 
in one hospital syphilitics composed almost 40 per cent, of the cases 
treated between the years 1861 and 1866. 



12 SYPHILIS INSONTIUM 

AUSTRALASIA AND OCEANICA. 

Some portions of these lands are yet free; others have been 
ravaged by the disease upon its introduction by the whites. In 
one of the Molucca Islands (Amboyna), a peculiar endemic 
prevailed early in the eighteenth century. A yaw-like disease 
(Tonga), has been noted in several localities. 

HAWAIIAN ISLANDS. 

Syphilis was first introduced here by Captain Cook's crew early 
in 1778, although Fornander 1 quotes Captain Cook as giving 
orders to prevent his men going freely on shore, saying, ' ' that I 
might do everything in my power to prevent the importation of a 
fatal disease into this island, which I knew some of our men now 
labored under, and which, unfortunately, had been already 
communicated by us to other islands in these seas. " Nevertheless 
syphilis gained a foothold and at once attained great gravity, and, 
owing to the very lax ideas of morality prevalent among the 
natives, the disease spread with very great rapidity; it is thought 
to have been one of the agencies which contributed largely to the 
well-known depopulation of the islands. It still exists there to a 
considerable extent, 2 although, as in so many other countries, it 
seems in a measure to have ''worn itself out," and is now in a 
quiescent condition. 

1 Fornander. An account of the Polynesian race. London, 1880, p. 161. 

2 Gulick. New York Journal of Med., March, 1855, p. 183. 



CHAPTER II. 

FORMS OF SYPHILIS.— I. AS A VENEREAL DISEASE (SYPHILIS PRAVORUm). 
II. AS A NON-VENEREAL DISEASE (SYPHILIS INNOCENTIUM OR 

INSONTIUM). DIVISIONS OF NON-VENEREAL SYPHILIS: 

I. SYPHILIS INGENITA: 2. SYPHILIS E COITU 
LEGITIMA : 3. SYPHILIS SINE COITU. 

Although the disease is one and the same under all circum- 
stances, syphilis may be conveniently studied under two grand 
subdivisions, according as it is acquired, 

First. In connection with illegitimate sexual intercourse, Syph- 
ilis pravorum, or venereal syphilis, and 

Second. As it occurs in a thoroughly innocent manner, Syphilis 
innocentium (or insontiutn) or non-venereal syphilis. 

In actual practice these are, of course, very closely related, 
one to the other, and the person who has acquired the disease from 
sexual transgressions not infrequently communicates it in an inno- 
cent manner ; and, conversely, one who receives the disease through 
innocent means may transmit the poison by venereal contact. As 
before stated, the disease is one and the same, however acquired; 
it runs the same course, presents the same symptoms, and requires 
the same treatment, which matters will not be here considered, 
as we have only to do with the mode of acquiring the disease. 

A. Syphilis pravorum. The first division, representing the dis- 
ease as acquired in illegitimate venereal indulgence, is largely 
connected with the history of prostitution, and has been abun- 
dantly considered in the various treatises on venereal disease, as 
well as in special works on syphilis, and many on prostitution ; in 
accordance with the plan of this work, this will not now be treated 
of, except incidentally. 

B. Syphilis insontium. The second division includes cases 
where the disease has been acquired in a wholly innocent manner, 



14 SYPHILIS INSONTIUM 

quite unconnected with any venereal transgression, and very 
frequently apart from any sexual relations. This second or non- 
venereal aspect of syphilis forms the basis of the present study, 
and it will be seen later that the disease, even acquired in this 
manner, occupies a conspicuous place in medical literature, and 
that syphilis insontium has been the source of untold damage to 
numberless inoffensive sufferers. 

It is undoubtedly and sadly true, that in the enormous majority 
of instances syphilis is acquired in illicit intercourse, and that the 
cases which shall be referred to later on are relatively rare, when 
compared to the immense number of instances in which the disease 
is communicated in the commonly-known manner. 

Since the date of the sudden and great spread of syphilis, to- 
ward the close of the fifteenth century, it has been known and 
classed as a venereal disease ; and, although the exact connection 
between the initial lesion and the constitutional symptoms was not 
recognised until many years later, it was constantly observed and 
remarked, that this new disease, as it was called, was commonly 
acquired in connection • with venereal transgressions, and earlier 
writers, as well as the laws of certain countries, contain constant 
reference to the fact. ! 

So far, indeed, has this been regarded as its only or main mode 
of transmission, that syphilis is almost invariably included among 
venereal diseases, even in the treatises on general medicine and 
surgery, and the magnitude of its position as one of the most im- 
portant and serious of the maladies which affect the human race 
has undoubtedly been undervalued, and its proper study has been 
retarded and hindered thereby. It may be stated without fear of 
contradiction, that in the minds of a large majority of persons, 
both in and out of the profession, the individual with syphilis is 
looked upon with suspicion, and the occurrence of the disease is 
still almost invariably associated with sexual errors; and, on the 
other hand, comparatively few appreciate, if indeed they know of, 
the various modes and occasions of the entrance of the syphilitic 
poison, in connection with which the recipient is entirely innocent. 

From these and other facts it has resulted, therefore, that many 
afflicted with syphilis have been wrongly suspected, while, again, 
many cases of the disease have passed unrecognized, simply be- 
cause of the failure to discover infection produced in the more 
common manner, in the genital region. How far its venereal 



FORMS OF SYPHILIS 15 

element is its only, or indeed its most important, aspect will be 
seen in the following pages. 

• While, as has been stated, syphilis commonly has a venereal 
origin, it is also true that very large numbers of cases have 
occurred where the disease has had its origin in a most unexpected 
and hitherto unknown manner, quite unconnected with any 
venereal or other error on the part of the person afflicted. The 
ways and methods by which this has occurred, far exceed anything 
which could have been imagined many years ago, and it is by no 
means probable that even now we know of more than a small pro- 
portion of the instances in which the disease has been thus 
acquired, nor do we yet recognize all the possibilities of non- 
venereal infection ; cases illustrating new methods of communi- 
cation are being constantly observed and reported, and the litera- 
ture of the subject is very great, and rapidly increasing. 

In looking at syphilis insontium, or, syphilis in the innocent, we 
find that the subject may be divided into three distinct heads, 
according to the mode in which the disease is acquired ; these are : 

1. Syphilis ingenita ; or inherited syphilis; 

2. Syphilis e coitu legitima ; or marital syphilis, and 

3. Syphilis sine coitu ; mainly, extra-genital syphilis. 

1. Syphilis ingenita. 1 The subject of the hereditary transmission 
of syphilis has been so abundantly studied, and the facts concern- 
ing it are so well known, through the works of Diday 2 , Baerens- 
prung 3 , Hutchinson 4 , Fournier 5 , and others, that it need not be 
considered in the present writing, and will only be alluded to 
incidentally, when bearing upon the subjects under consideration. 

2. Syphilis e coitu legitima. Marital syphilis, or that acquired 
in lawful wedlock, is a subject which is second in importance to 
none in connection with the study of syphilis insontium, and here, 
alas, are some of the saddest cases to be observed; it is in the 
family relations that the physician often stands as a bulwark to 
protect the health, peace, and happiness of the home, and the sub- 
ject demands the most careful consideration from everyone who 

1 This is a better term than syphilis congenita, inasmuch as congenital syphilis may represent both 
the inherited disease and that acquired at birth, from any external source : ingenita signifies " inborn," 
a stronger expression even than '"hereditaria.'' 1 

2 Diday. A treatise on Syphilis of New-born Children. New Syd. Soc. Ed., London, 1859. 

3 Baerensprung. Die hereditare Syphilis. Berlin, 1864. 

* Hutchinson. A clinical memoire on certain diseases of the eye and ear consequent upon in- 
herited Syph. London, 1863. 

5 Fournier. La Syphilis hereditaire tardive. Paris, 1886. 



1 6 SYPHILIS INSONTIUM 

at any time may have syphilitic patients under observation and 
treatment ; for, as will be seen later, a very considerable share of 
the women who have syphilis have acquired it in this manner. 
But this subject has been so thoroughly elaborated, through the 
labors of Langlebert 1 and Fournier 2 and Diday 3 , that there is 
little further need of work in this line, and it will not be con- 
sidered especially in the present connection. 

3. Syphilis sin a coiiu. The third group of cases belonging to 
syphilis insontium, namely, such as are acquired in other manners 
than those alluded to, and the primary lesions of which are 
commonly extragenital, is perhaps one of the most important of 
all, and worthy the closest study and most thoughtful attention. 
The reasons for this are, that, on the one hand, the dangers 
extend to every one, married and unmarried, and even to innocent 
children; while, on the other hand, these dangers are but little 
known and appreciated by the profession, to say nothing of 
the gross ignorance and consequent carelessness of the laity in 
regard to the matter. 

To develop this branch of the subject will be the aim of the 
succeeding pages. 

The following table exhibits a classification of the various 
non-venereal modes of infection which have been actually reported 
in literature, arranged according to the various aspects of life in 
which they occur : 

1 Langlebert. La Syphilis dans ses rapports avec le mariage. Paris, 1875. 

2 Fournier. Syphilis et Mariage. Paris, 1880. 

» Diday. Le peril venerien dans la famille Paris, 188 1. 



CLASSIFICATION OF THE MODES OF 
INFECTION OF SYPHILIS* 



Syphilis 




e coitu illicita. 
ingenita, vel he- 
reditaria, 
e coitu legitima. 
sine coitu. 



not considered in 
the present work. 



SYPHILIS INSONTIUM SINE COITU 

a o , -t -, . f i . epidemica. 

A. Syphilis pandemica •< r -, 

Jr r (2. endemica. 



B. 



Syphilis 
pandemica 





w- 


economica. 


s sporadica 


I 2 - 


brephotrophica. 




U 


technica. 




r i. 


From cupping. 




2. 


" bre ast- drawing. 




3- 


' ' hand raising of infants. 


I. 


4- 


" lactation. 


5- 


accouchement. 


Syphilis 


6. 
7- 


' ' circumcision. 
' ' vaccination. 


Epidemica 


8. 


eating and drinking, and domestic 
propagation. 




9- 


' ' tattooing. 




10. 


" glass blowing. 




ii. 


" eustachian catheterization. 




L 12. 


' ' application of tongue to eye. 




r i. 


Sibbens. 




2. 


Radesyge. 




3- 


Disease of St. Paul's Bay. 




4- 


Amboyna Pustule. 




5- 


Morbus Dithmarensis. 




6. 


Facaldina. 


II. 


7- 


Scherljevo. 


8. 


Mai di Breno. 


<» L ' 1 ' 


9- 


Frenga. 


Syphilis 


IO. 


Spirocolon. 


Endemica 


ii. 


Morula. 




12. 


Mai Kabyle. 




13- 


Yang-mey-tchoang. 




14- 


Syphiloid of Courland, Jutland, Lithu- 
ania, Hesse, Klein-russland, etc. 




15- 


(?) Frambcesia, Yaws, Pian. 




16. 


(?) Aleppo Evil, Biskra Bouton, Chancre 
du Sahara, Caneotica, Delhi Boil, Scinde 






Boil, Parangi, etc. 



♦The data in the Synopsis of Facts and Literature, and also the material of the body of the 
Essay, are arranged in accordance with this scheme, and the details of each feature may be found by 
referring to the same. (See Synopsis of Facts and Literature at end of volume.) 



3 



B. 



Syphilis 
sporadica 



Syphilis 
Econom. 
ica 



Domestic 
and 
Social 
trans- 
mission 



1. 

Eating 
and 

drinking 
and the 
use of 
Tobacco I 



2. 

Personal 
and 
house- 
hold 
effects 



1. 

Implements and 



vessels 



Tobacco, 
Troches, etc. 



i. Spoons, knives, forks. 
2. Cups, glasses, jugs. 



Tobacco-pipes. 

Cigars and cigarettes 

(mouth to mouth). 
Cigars (infected by makers 

etc.). 
Troches. 



i. Shirts, drawers, etc. 

2. Masks. 

3. Plasters, bandages, 
etc. 



lint. 



1. 

Wearing apparel, 
etc. 

2. 

Bedding \ Pillows, sheets, etc. 



1. Towels, sponges, etc. 

2. Combs. 

3. Tooth brushes, etc. 

4. Syringes. 

) 5. Sick-chairs, privy seats, 

etc. 
I 6. Other methods in family 
I life. 

f 1. Handkerchiefs. 

I 2. Pins. 

I 3. Canes. 

L 4. Opera glasses. 



3. 

Toilet articles. 



4. 

Miscellaneous 
articles 



r 1. 

Buccal 



Active 
and tem- 
porary- 
contact 



1. 

Kissing 



2. 

I Biting 



2. 

L Digital \ 




1. Reciprocal. 

2. Non-reciprocal. 



1. As a caress. 

2. For defence or assault. 

3. Accidental tooth wounds. 



Auto-infection (poison con- 
veyed by own act). 

Hetero-infection (poison 
conveyed by another's 
act). 



wounds ( 



4. 

Passive 
contact 



Industrial 
trans- 
mission 



1. 

Buccal 



2. 

1 Digital 



By occupation re- 
quiring use of 
the mouth 



2. 

By necessary or un- 
necessary use of 
the lips. 



By substances in- 
fecting the fingers 



1. Scratching. 

2. Pinching. 



Contact in sleep. 
Contact in carrying, 
porting, etc. 



1. Glassblowers (pipes). 



sup- 



Assayers (blowpipes). 
Weavers (spinklers). 
Musicians (wind instru- 
ments). 
Conductors (whistles). 
Servants (speaking tubes). 



1. Cooks (tasting spoons). 

2. Furriers (thread). 

3. Upholsterers (tacks). 

4. Shoemakers (pegs). 

5. Clerks (pens, pencils, etc.). 

6. Cashiers and others 

(money, etc.). 

7. Druggists (labels, etc.). 

8. Artificial flower makers 

(needles, etc.) 



Laundresses. 

Old clothes dealers, rag- 
pickers. 



B. 

Syphilis 
sporad- 

ICA 

(contin- 
ued) 



II- 

Syphilis 
Brepho- 

troph- 

ica 



Acquired 
through 
nutri- 
tion of 
infants 



By lacta- 
tion 



2. 

By hand- 
feeding 
of 

infants 



1. 

Nurse 
infected 
by nurs- 
ling 



2. 

Nursling 
infected 
by 

nurse 
or by 
another 
nurs- 
ling 



Adults 
infected 



2. 

Infants 
infected 



Nursling heredita- 
rily syphilitic 



| Nursling having 
l acquired syphilis 



1. 

Nurse has prim- 
ary lesion of the 
breast 



Nurse has recent 
syphilis but no 
chancre of the 
breast 



Another nursling 
L the syphilifer 

r i. 

By new-born he- 
reditarily syph- 
! ilitic children 

S 2. 

I In weaning child- 
ren with hered- 
I itary or acquired 

L_ syphilis 



r i. 



r*- 



Nurse the mother (ex- 
ception to Colles Law) 
Nurse not the mother. 

Acquired in lactation. 

Acquired by kissing 
or otherwise per os. 

Acquired by vaccina- 
tion, circumcision, etc. 

Child infected in lacta- 
tion. 

Child infected by kiss- 
ing and otherwise at 
nipple. 

Child infected from 
mucous patches on 
nipple. 

2. Child infected from a 

nipple contaminated 
by soiled fingers, etc. 

3. By supposed infection 

through the milk. * 

Nipple the medium of 
transmission. 



Nursing bottles. 
Artificial teats. 
Chewing the food for 

child. 
Spoons, cups, and 

other objects. 



2. 

Acquired 
in con- 
nection 
with at- 
tend- 
ance on 
infants 



Mediate contact with 
soiled articles (infant 
alone infected) 



By attendants 
j 

i 2 - 

I By other child f os- 

^ tered with it 
Toilet articles 



f 1. Nursing bottles. 
J 2. Artificial teats. 
j 3. Chewing the food. 
[_ 4. Spoons, cups, etc. 



By use of same imple- 
ments, nursing bottles, 
etc. 



2. 

Direct 
contact 



Active, 
limited ^ 
contact 




f 1. Wash water. 

2. Sponges, etc. 

3. Combs. 

4. .Syringes. 

( 1. Diapers. 

. Cradle clothing. 



1. Reciprocal 

2. Non-recip- 
rocal. 



C Adults 



fants 
nfected. 



Is 



2. 

Passive 
contac. 



^ Aerial 

I In parturition 

2. 
J During slumber 
i (in bed) 



Accidental ! Adults 
tooth wounds j infected. 



. Adult receives chancre. 
. Infant infected by at- 
tendant. 
Distal infection by own 

soiled fingers. 
Infection by infant's 
soiled fingers. 



By nail- -/ Adults usually infected. 
t, wounds ( 

j By blowing or sputtering 
/ "in infant's face. 



j Infection per partum (in- 
j fant alone infected). 

j Contact in bed (infant or 

I . adult infected). 



^ By contact in arms j 2. 



Adult infected. 
Infant infected. 



*9 



B. 



nica 



Operator 
the 
victim 



Unnecessary exposure 
f 1. 

Manual (digital) 



j Auto-inoculation 
| (purely accidental) 



2, 



Neces- 
sary 
expos- 
ure 



Cephalic, 



1. 



Buccal. 



Facial. 



Syphilis 




sporad- 




ICA 




(contin- 


2. 


ued) 






Operator 




the 


III. 


syphi- 


Syphilis 


lifer 


Tech- 





Direct 
contact 



1. 

Digital 
contact 



Infecting 
finger 
seat of 
chancre 

2. 

Infecting finger soiled 
saliva, etc. 



With a wound. 



Buccal 
I contact 



Without a wound. 



I Instrumental contact 



(Instrument soiled with 
operator's saliva) 



Operator 
the 
medium 



By means of transplantation 
and inoculation 



2. 

« By means of 
unclean "j 
instruments 



Cutting 
instruments 



i. Operative. 
2. Cadaveric. 



U 

i: 



i. 

Chirurgical 
manipulations 

2. 

Obstetiical 
manipulations 



by 



Surgeons. 
Accoucheurs. 
Dentists. 
Attendants. 

Breast drawing. 
Wound sucking. 
Inflating lungs of new- 
born. 
Applying tongue to eye 

f i. Infection by own fin- 
I gers. 

J 2. Direct contact. 
I 3. Aerial transmission 
(coughing in face, 
I etc.). 

( Infection by vaginal anal 
■i and other explora- 

( tions. 

j 1. Mother mfected. 
( 2. Infant infected. 

New-born infected (at 
umbilicus). 

Infection by raising 
palate and like pro- 
cedures. 



Wound sucking. 

Office of \ sylle 

cumcision). 



(cir- 



Solid, organiz- 
ed substances 

2. 

Liquid 
substances 



1. 

Wound 
accidental 



Wound 
intentional 



2. 

ta Blunt instruments. 



By means of 
unclean 
substances 



1. 

In suspension 

2. 

^ On bandages, lint, etc. 



1. Breast drawing. 

2. Removing foreign 

bodies from the eye. 

1. Tattooing (needle). 

2. Cupping (as done in 

Finland). 

1. Transplanting teeth. 

2. Skm grafting. 

1. Vaccination (from pri- 

mary or secondary 
syphilised vesicle). 

2. Variolation. 

• 3- Syphilisation. 

1. Dental instruments. 

2. Infection in razor 

wounds. 

1. Phlebotomy. 

2. Minor surgery. 

3. Wet cupping.. 

4. Leech bites. ■ v 

5. Tattooing (needles in- 

fected from previous 
subject;. 

6. Vaccinatum (soiled in- 

struments, etc.). 

1. Eustachian catheteri- 

zation. 

2. Sounds and specula. 

3. Sierres fines, portes 

caustiques, and 
other apparatus. 

4. Tongue spatulas.' 

5. Svringes. 

1. Wash water. 

2. In local therapeutics. 

1. In surgical dressings.. 

2. In circumcision. 



CHAPTER III 



SYPHILIS INSONTIUM SINE COITU. — CLINICAL CONSIDERATIONS. MODES 

OF INFECTION: IMMEDIATE CONTAGION, MEDIATE CON- 
TAGION. LOCATION OF PRIMARY LESIONS. 

The methods by which non-venereal syphilis may be acquired 
are innumerable, and relate to every conceivable circumstance and 
surrounding of life. As each new case or series of cases is re- 
ported, it becomes more and more probable that the number of 
instances in which syphilitic infection has thus occurred is far 
greater than is commonly supposed. 

With a poison so virulent, and capable of being transported 
and introduced in so many different ways, endowed with the possi- 
bility, as far as is known, of being preserved for an indefinite 
period, the only wonder is, that cases of the non-venereal commu- 
nication of syphilis to innocent victims are not even more common 
than they are now known to be. 

The explanation of the relatively greater frequency of cases of 
venereal syphilis, is found in the nature of the virus, which requires 
a broken or abraded surface of skin or mucous membrane for its 
admission. This solution of continuity may be produced at the 
time of inoculation, or, infection may take place in the site of an 
old injury or abrasion; or, sometimes it would appear that the 
poison may itself cause an erosion of the surface, if long retained 
between folds of the mucous membrane. 

When the conditions for its entrance are all present, it will be 
seen that inoculation rarely fails to take place on any and every 
portion of the body. But in the genital region the delicate char- 
acter of the mucous membrane, and the frequent abrasions which 
occur during coitus, together with those arising from herpes, 
eczema, or other conditions, afford a ready entrance for the poison, 



2 2 SYPHILIS INSONTIUM 

which is also further favored by prolonged contact, together with 
heat and moisture. 

It will not be necessary to discuss here the nature of syphilis, 
or the physiological and pathological questions connected with its 
mode of entering the economy and development therein, nor need 
we enter upon the subject of any possible relationship between the 
chancroid and the chancre, or initial lesion of syphilis; these 
topics are somewhat foreign to our subject and have been abun- 
dantly considered elsewhere. It is here understood that we are 
dealing with true syphilis, which is a specific infectious disease, 
always communicated by the direct transference of a contagious 
principle, of whose real nature we know little, which induces a 
similar disease in another person. The point of entry of the 
syphilitic contagion is marked by a sore, called the initial lesion or 
chancre ; this may and does present a great variety of appearances 
according to its location, the health of the individual, the treatment 
employed, and possibly other conditions which cannot be explained. 
In some instances it presents a striking, ulcerative surface, in others 
the lesion may be so slight as to have attracted little or no attention • 
it may remain for some considerable length of time, yielding only 
slowly to constitutional treatment, or again it may disappear rapidly 
under even the mildest local measures alone. 

The only exception to the existence of the local sore as the first 
manifestation of syphilitic infection, is found in inherited syphilis, 
where the offspring receives the disease with its life or through its 
uterine nourishment, and also in the probable, though not wholly 
proven, infection of the mother through a foetus, which has 
inherited syphilis from its father. 

In studying the subject of the communication of syphilis, we 
find two methods of transference of the poison : 

First, by immediate infection, or the direct contact of one person 
with another, and 

Second, by mediate infection, where the infective principle of the 
disease is conveyed on some material object, in the same manner 
as vaccine virus is carried on a quill, or ivory point, or the lancet. 

By these two methods alone can inoculation take place, and 
sufficient care in investigation will often, if not always, reveal the 
exact mode in which the accident has occurred. It is to be re- 
membered that there is no occult manner in which the disease can 
be acquired, that it is not transmitted by the breath or through the 



IMMEDIATE AND ME3IATE INFECTION 23 

air, as are other infectious diseases, nor is the disease gotten by 
anv simple nearness to the affected person, or by contact, unless 
there has been an actual transference of the poison from one in- 
diviual to another. 

1. Immediate infection. Of these two methods of communi- 
cating the disease, this is by far the more common, and is the mode 
in which most cases of venereal syphilis are acquired. Many cases 
of syphilis in the innocent are also caused thus by direct contact r 
as in the case of kissing, biting, etc., and also in the infection 
occurring between nurslings and nurses, and otherwise. 

2. Mediate infection. While much less frequent, this method 
of infection is, in one sense, much more important than the former, 
because of its insidious character, the source of infection often 
being unsuspected until long after the disease has become fully 
developed in the victim. A large number of the cases of syphilis 
insontium occur through mediate infection, and the time of the de- 
posit of the virus on the mediate article and its absorption by the 
victim are commonly unknown; much of the seemingly occult 
nature of many cases of syphilis may be thus explained. 

In the greater proportion of instances of non-venereal syphilis, 
the virus comes from mucous patches, generally from those seated 
upon the lips and tongue ; in some cases the material is taken di- 
rectly from a chancre, and in a few instances the source of conta- 
gion is syphilitic blood : still more rarely the disease is acquired 
through pus or other products of the syphilitic process. 

It is not believed that normal secretions, such as the saliva, 
milk, or tears can communicate the disease : in cases where this is 
supposed to have occurred, there have probably been mingled with 
the* secretions some of the products of syphilis, as that from mu- 
cous patches or possibly blood, which have been the active agents 
in communicating the disease. 

In regard to the semen, it is well recognized that this does 
transmit the poison to the product of conception, so that the child 
may inherit syphilis directly from the father, without the mother 
having actively acquired the disease ; it is also an accepted fact 
that the mother does become in some manner infected or protected 
thereby, so that she is no longer capable of acquiring syphilis from 
her own child in nursing or otherwise, even although she may not 
herself have exhibited any signs of syphilitic disease ; but to this 
so called "Colics' law" exceptions have been reported. 



24 SYPHILIS INSONTIUM 

It is, however, hj no means proven that the semen can convey 
syphilis otherwise than through the agency of conception, although 
certain cases have been reported of the alleged acquiring of the 
disease in this manner, and Baumler 1 thinks it probable that infec- 
tion can thus happen ; it seems more likely that in these cases some 
secretion from a diseased mucous membrane, becoming mixed with 
the semen, had been the real conveyor of the poison. 

In cases of immediate contagion the date and circumstances of the 
communication of the disease may commonly be made out, but in 
many cases of mediate contagion it is often extremely difficult to 
determine whence the poison is obtained, or exactly when the 
poison was absorbed ; a striking illustration of this will be men- 
tioned later on in connection with circumcision syphilis. 

Exira-genital chancres. The subject of extragenital chancres 
has received considerable attention at the hands of many observers, 
and instances may be found where the initial lesion of syphilis has 
been seated on every conceivable portion of the body. While the 
topic under consideration is syphilis inso?itium rather than that of 
extra-genital infection, which latter, as is well known, may be of 
venereal origin, it may be well to briefly allude to the statistics 
accessible in reference to the location of extra-genital chancres, as 
indicating in some measure the relative possible frequency of syph- 
ilis insontium. 

The following table is compiled from cases observed in the 
venereal clinics in the large cities of Europe, care being exercised 
to avoid duplication of statistics, which has occurred repeatedly in 
some of the published tables of like character. Separate special 
reports in regard to large numbers of cases of extra-genital chan- 
cres, affecting different regions alone, as on the lips, tongue, throat, 
eye, etc., have been excluded from these statistics, and will appear 
in another table (Table III.), as the object now is to show the 
relative frequency between genital and extra-genital chancres, in 
ordinary venereal practice. 

1 Baumler. Ziemssen's Handb. der spec. Pathol, u Therapie. Bd. III., T. I., 3d ed. Leipzig, 

1886, pp. 46, 47. 



EXTRA-GENITAL AND GENITAL CHANCRES 



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26 SYPHILIS INSONTIUM ■ 

In this table, comprising 7123 cases, we find the initial lesion is 
recorded as extra-genital in 353 instances, or almost five per cent, 
of the entire number, and the chancres are found on almost every 
portion of the body. But it is to be remembered that extra-genital 
chancres are really very much more frequent than would be indi- 
cated by the numbers here presented, for these data are furnished 
chiefly from venereal clinics, where those go mainly who are sup- 
posed to have diseases acquired in sexual intercourse. But in addi- 
tion to the cases of extra-genital chancre which would be thus seen, 
casually, as it were, there are large numbers of innocent inocula- 
tions of syphilis, happening in foundling-asylums and elsewhere, 
in addition to the many which have been observed in special 
clinics, such as those for the eye, throat, skin-diseases, etc., which 
would not enter any general venereal statistics: it is probable, 
therefore, that the real percentage of extra-genital chancres w T ould 
be very much increased, probably duubled by these additions, so 
that they would form possibly ten per cent, of the whole. 1 

The statistics in regard to the relative frequency of extra-genital 
chancres are found to vary greatly as given by different reporters, 
being always very much larger in cases of syphilis observed among 
females. The reason for this latter' fact is probably found in the 
circumstance that it is frequently difficult to discover the primary 
lesion upon the genitals of females, it being often deeply seated, 
and more commonly overlooked, for various reasons ; so that, the 
total number of genital chancres actually seen in this sex would 
naturally be much less than in an equal number of male syphi- 
litics. On the other hand, extra-genital chancres would, if any- 
thing, be rather more likely to be complained of and noticed in 
females. To this must be added the additional risks of infection 
in the latter, especially in the matter of marital exposure, in lac- 
tation, and in the care of syphilitic infants. 

Thus, among 2618 cases of chancre in the male, recorded by 
Bassereau, Robert, Fournier, Sigmund, Lefort, Pellizzari and 
Breda, there were 156 instances of extra-genital chancre, or a trifle 
under six per cent. ; whereas among 926 cases of chancre in the 
fe?nale, recorded at the St. Lazare, Lourcine, and at Vienna, 

1 If any should think that this percentage is too high, let it be remembered that in a considerable 
proportion of cases of constitutional syphilis which come to any one for treatment, the actual site of the 
primary lesion is not known with certainty, especially in regard to women ; since the attention of the 
writer has been especially directed to this subject, for ten years past, he has been greatly surprised at 
the number of extra genital (and mostly innocent) chancres that have been found Dy a little careful 
searching in his clinics. 



EXTRA-GENITAL INFECTION IN FEMALES 27 

Florence and Padua, there were no which were extra-genital, or 
nearly twelve per cent. 

We have no means of forming an accurate estimate of the pro- 
portion of non-venereal cases among these 353 instances of extra- 
genital chancre given in Table I, but from what will appear later 
it is probable that a very large number were of this nature. 
Fournier 1 has recently furnished some interesting data bearing 
on this subject of syphilis insontium, from his private practice, 
which will aid us in understanding the relative frequency of this 
form of syphilis. Among 887 cases of syphilis in females, he found 
that in 842 cases the origin was sexual, and in 45 cases, or 5.07 
per cent., the disease was acquired in a non-venereal manner. 

These cases were as follows : 

TABLE II. 
Cases of Non-Sexual Syphilis ill females i7i private practice (Fournier). 

Cases of domestic contagion, derived from nurslings, children, 
wet-nurses, or nursery maids with syphilis fall the cases 
occurring in married women or young children), . .12 
Cases of infection transmitted to nurses by children heredi- 
tarily syphilitic, 3 

Cases of hereditary syphilis, 7 

Cases of midwives infected on the finger in the exercise of 

their profession, ........ 5 

Cases of syphilis acquired accidentally in infancy, ... 4 
Cases of syphilis communicated by vaccination, . . . 2 
Cases of syphilis communicated by Eustachian catheteriza- 
tion, 2 

Cases of syphilis communicated by rape, .... 1 

Cases of unknown origin, but certainly non-venereal, . . 4 

Total cases of syphilis insontium, 45 

Among the remaining 842 cases there were 220 married women, 
and about an equal number whose social position was not recorded, 
some of whom might have been married : the remainder, 366, were 
unquestionably public characters. Of the 220 married women 
there were 56 doubtful cases, who were excluded, as either having 
contracted syphilis from a lover, or for other reasons, leaving 164 
infected honestly and innocently, in their married relations; of 
the 164 husbands of these women, Fournier found that 82 had 
contracted syphilis before marriage, 39 after marriage, and in 41 
cases the date of infection was not recorded. Thus, after the 
elimination of all doubtful cases, he found that of all the females 

1 Fournier. Annales de Dermatol, et de Syphiligraphie, tome VIII., No. 12 (1887), p. 757. 



28 SYPHILIS INSONTIUM 

consulting him who had contracted syphilis from sexual inter- 
course, nearly 20 per cent, were married women, infected inno- 
cently, through no fault of their own. Adding this to the 5 per 
cent, of the first class, he states that, in his experience, in private 
practice, nearly 25 percent, of the females contracted the disease 
innocently and undeservedly. In the discussion on the paper, 
Ricord stated that the matter had not been at all exaggerated, but 
that he himself had met with fully the same percentage. 

My own statistics, although considerably smaller, tell a much 
sadder story. Taking 5 00 recent cases of syphilis, in private practice, 
there are found to be 339 males to 161 females, the latter forming 
about 7,2 per cent. Of these latter there were 120 who were married 
or widows, and 41 single, or children ; among them were 20 cases of 
inherited syphilis. Of the 120 married or widowed women 10 had 
obtained their disease through extra-genital chancres, and two had 
late hereditary syphilis, leaving 108 to be accounted for by other 
means of infection. After a very careful examination of the his- 
tories of the patients, and the exclusion of all doubtful cases, I am 
positive that in over 50 per cent, of these married women the dis- 
ease was contracted innocently from their own husbands: in a 
dozen or more instances the husband was either under my treat- 
ment or observation for syphilis, and recognized the source of in- 
fection. Adding together then, the 10 cases of extra genital 
chancre, 20 of hereditary syphilis, and 54 infected wives, we 
have 82 cases, or over 50 per cent, of all the females in private 
practice, in which syphilis was innocently acquired. 

It will be seen later, that males are also exposed to syphilis 
insontium, and may acquire the disease quite as innocently as in 
the instances of females just cited : indeed among the personal cases 
recorded in Chapter IV. the male cases were actually in excess of 
the females. In the case of hereditary syphilis, and brepho- 
trophic syphilis, male children are, of course equally exposed with 
female children, while in the ordinary domestic exposure males 
and females are alike liable to contract the disease ; there are even 
some elements, such as the smoking of pipes and cigars, which in- 
crease the proportion of the males. Furthermore, many occupations 
and circumstances render men peculiarly subject to the contagion ; 
thus, surgeons and accoucheurs are constantly exposed to the infec- 
tion of syphilis, and a very considerable number, from first to last, 
have acquired the disease in their profession; many cases have 



LOCATION OF EXTRA-GENITAL CHANCRES 29 

likewise occurred among glass-blowers, as also in some other 
trades. Syphilis has also repeatedly been given in tattooing, 
which is rarely practiced in females, while in earlier years it was 
also not infrequently communicated in circumcision. 

It would seem therefore that putting these statistics and facts 
together, there must be at least ten per cent, and possibly a much 
larger proportion of cases of syphilis which are acquired in a per- 
fectly innocent manner. The statistics just quoted from Fournier, 
it is to be remembered, are taken from his private practice alone, 
and are thus supposed to represent the better and more intelligent 
classes in Paris; it is altogether probable that among the more 
ignorant and careless communities of peasants, where the disease 
has sometimes spread over large districts, there is a very much 
greater proportion of cases of syphilis insontium, as may be judged 
from the facts developed in Chapter VI. , in regard to epidemic 
and endemic syphilis. 

LOCATION OF EXTRA-GENITAL CHANCRES. 

We may now briefly allude to the localities where the infecting 
sore has been recorded to have occurred, and will present some 
statistics from which may be judged the relative liability of the 
various portions of the body to be infected. The following Table 
III. has been prepared by adding together the individual instances 
of extra-genital chancre reported by different observers in the 
countries there indicated, as presented in the Analytical Biblio- 
graphy at the end of this work : the very greatest care has been 
exercised to avoid any possible repetition of cases, by consulting 
the original reports of the same, and excluding the statistics which 
have been at times tabulated by others : the cases here compiled are 
recorded by several thousand individual observers. It is not sup- 
posed that all of the cases on record are here tabulated, but enough 
have been collected to indicate both the large numbers of reported 
cases of extra-genital infection, and the relative frequency of the 
sore in different localities. The table presents the analysis of 9058 
cases of extra-genital chancre. It would be very much larger if we 
could include multitudes of cases where the location of the sore is 
not accurately stated, such as those reported "from eating and 
drinking, " " from care of children, " and the very large numbers of 
infants infected in Russia and elsewhere " by means of nursing." 



3° 



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LOCATION OF EXTRA-GENITAL CHANCRES 31 

We may now consider briefly some of the features presented 
by the figures here presented. 

Chancre of the lips is seen, in this table to take the first rank, in 
point of frequency, reaching the great total of 1810 cases, or 
almost 20 per cent, of the entire number. It will be further seen 
that the preponderance of these cases come from France, Belgium, 
and Colonies, and of these a large share occurred in Paris, where 
much attention has been paid to extra-genital chancres. 

Chancre of the breast comes next in frequency, with a total of 
1 148 cases, or 12.5 percent, of the whole. Here Italy takes the 
lead, furnishing nearly one-third of the cases: Russia and Poland, 
and France also give large numbers, in all of which countries 
baby-farming is very prevalent. The numbers of cases of chancre 
of the breast would probably be very much greater if the instances 
of infection by nursing, mentioned in connection with epidemics 
and elsewhere could be included : but as the exact location of the 
site of infection is often not noted, these cases cannot be exactly 
located in this table. 

Chancre of the buccal cavity forms the next most frequently re- 
ported locality, with 734 cases, or over 8 per cent. : of these 447 
were from Russia and Poland. In these instances there was no 
more exact location stated, but it will be observed that there 
are several other columns, representing infection in the tonsils, 
throat, tongue, and gums, representing a total of 1504 cases; 
thus, in over sixteen and a half per cent, infection took place within 
the cavity of the mouth, which would place this locality next to 
the lips in frequency. 

Combining these with the 18 10 cases of chancre of the lips, we 
have no less than 3,314 cases, or 36.5 per cent, of the whole number 
analyzed, where infection occurred in the region of the mouth. 

Chancre of the fingers and hand. This presents the next most 
frequently reported site of infection, with 462 cases, or over 5 per 
cent, of the total number analyzed. The majority of these cases 
were reported in accoucheurs and midwives. 

Chaticre of the eyelids and conjunctiva comes next on the list, with 
372 cases, or over 4 per cent, of all. De Beck has written a very 
complete essay on the subject, in which he gives in tabular form 
the facts relating to 94 collected cases, including nine not previously 
published, one of them being his own: a number of these were in 
children, the youngest being eight months of age and the oldest 



32 SYPHILIS INSONTIUM 

45 years, although several are spoken of as being "old." The 
causes and modes of infection were various : several cases were in 
physicians and midwives, who conveyed the poison to the eye by 
means of fingers ; in two instances physicians received the infec- 
tion from patients coughing in the face. In a considerable num- 
ber the chancre was acquired in a manner similar to that mentioned 
in Chapter VI. (Epidemic No. T04), namely from the attempt to 
remove foreign particles from the eye with the tongue, the person 
performing the office being syphilitic. 

Chancre of the tonsil. The tonsils, one or both, were reported 
to be the site of primary syphilitic infection in 307 cases, or just 
three and a half per cent, of all the cases of extra-genital chancre. 
Here again France leads the list, with 43 per cent, of the whole. 
The alleged causes of tonsillar chancre were many ; from kissing, 
smoking pipes, glass blowing, tasting of feeding bottles, etc., and 
relatively very few were from improper practices. 

Chancre of the throat, and of the deep nasal and oral passages. Of 
these we find 264 cases or nearly three per cent., the larger num- 
ber coming from Russia and Poland : undoubtedly many of these, 
as also those previously noticed as in the buccal cavity, were 
chancres of the tonsil. In 1884 Schadek published a paper on the 
subject, giving 68 cases, three of them personal; Petersen and 
Tshistjakoff the next year wrote also, and the latter counted up 
1 04 reported cases. Almost every portion of the pharynx has been 
reported as the seat of the primary lesion of syphilis, including the 
posterior surface of the velum (Zeissl) and the upper face of the 
epiglottis (Krishaber 1 ). The cases of inoculation from Eustachian 
catheterization come under this class. 

Chancre of the tongue appears to be less frequent on this list 
than might be expected, there being only 157 cases, or about 1.7 
per cent. In the older epidemics the tongue was frequently 
spoken of as a common site of inoculation, and possibly from its being 
a well recognized site of infection, observers have been less prone 
to report individual cases than those in less probable and more 
unusual situations. Writers on infantile syphilis often speak of 
infants at the breast receiving the infection in this location ; thus, 
Pellizzari, out of 54 instances of infantile syphilis reports having 
found " the primary sore on the lips, tongue and gingival border" 
in 30 cases. 



1 Krishaber. Solis Cohen, Diseases of the Throat and Nose : 2d edit. Philadelphia, 1879 : p. 17. 



LOCATION OF EXTRA-GENITAL CHANCRES 33 

Chancre of the chin comes next in frequency, with 146 cases; 
the cheeks give 145 cases; the nose 95 cases; the forehead and temples 
37 cases; and the ear 27 cases, a total of 450 cases on the exposed 
surface of the face, exclusive of the lips and eyelids. A very great 
variety of causes are given for the infection : many of them were 
from bites and scratches, the latter often from infants with in- 
herited or acquired syphilis. 

Anal and peri-genital chancres are, of course, very much more 
frequent than are indicated by the figures here given, 87 and 77 
respectively ; large numbers are found recorded in connection with 
venereal clinics, which are excluded here. 

Vaccination is known to have been the means of the communi- 
tionof syphilis in numbers of instances, there having occurred many 
epidemics of syphilis insontium from this source, as will be more 
fully dwelt upon in Chapter VI. The total number of victims 
here mentioned, 1863 is all that could be collected in actual num- 
bers from literature, but in many instances the statement is made 
that ' ' large numbers " were infected. During the late civil war in 
the United States groups of soldiers were known to be thus syph- 
ilized in several localities, and probably but a few of the occurrences 
were ever reported. Foster gives several of these epidemics, and 
summarizes the material bearing on the subject up to 1870, here 
and in other countries. 

Cupping and phlebotomy, as practiced in olden times, and among 
ignorant communities, yielded a large number of cases of innocent 
syphilitic infection; the total number collected being 745, or over 
eight per cent, of the whole number here analyzed. From 
more recent reports from Russia and Finland these cases con- 
tinue to appear from this cause from time to time. 

Circumcision, more particularly ritual circumcision, and among 
the lower classes, has been recorded by a number of observers as 
having been followed by syphilis : of the total number collected, 
179, it will be noticed that 119, or almost 70 per cent., came from 
Russia and Poland. These cases illustrate forcibly the fact that 
the site of infection in syphilis insontium may even come on the 
genital organs, as is also repeatedly shown elsewhere, in the in- 
stances where husbands acquire chancre of the penis from wives 
who had been infected by syphilitic nurslings. 

Tattooing has repeatedly given rise to groups of cases of syphi- 
litic infection : it is curious to notice that of the 82 cases here 

4 



34 SYPHILIS INSONTIUM 

collected, the United States furnished over one-half, the rest being- 
from English and French sources. Berchon 1 and Lacassagne 2 
make no mention of syphilitic inoculation in their elaborate studies 
on the subject of tattooing, although the former very briefly refers 
to a case reported by Hutin. 

We have thus seen that every portion of the body has been the 
site of the primary lesion of syphilis, and if the exact and minute 
location of the sore, in every case which has occurred could be 
accurately determined, it would probably be found that not a 
square inch of the body has at one time or another escaped being- 
the seat of a chancre. The methods by which this has happened 
will be more particularly studied in subsequent chapters. 
; ; * 

1 Berchon, E„ Histoire med. du Tatouage. Paris, 1869. 

2 Lacassagne, A. Les Tatouages, Etude anthrop. et med. leg. Paris, 1881. 



CHAPTER IV. 

CLINICAL CONSIDERATIONS. PERSONAL CASES. CHANCRES OF THE 

LIP, TONSIL, FINGER, BREAST, TONGUE, CHEEK, EYELID, 

CHIN, HAND, NOSE, EAR, TEMPLE, NECK, 

FOREARM, AND SACRAL REGION. 

The clinical appearances presented by extra-genital chancres 
vary very greatly according to their location, their duration, pre- 
vious treatment, and many other factors which cannot be deter- 
mined. It would be beyond the. scope of the present essay to 
attempt any complete description of the characters or appearance 
of the initial lesion of syphilis as it appears on various portions of 
the body, as the present work relates mainly to the danger and 
modes of innocent syphilitic infection and does not include a 
complete study of the disease in all its relations. 

It may be interesting and instructive, however, to have some 
clinical pictures of syphilis as it has presented itself in connection 
with non-venereal infection, and I have, therefore, collected 
together the notes of the cases which have fallen under my obser- 
vation and care, and present them somewhat in detail. While 
these cases may not exhibit absolutely every phase of extra-genital 
sores, enough can be learned from the clinical descriptions given 
to enable one to recognize such chancres in any location. 

In examining the records of my public and private practice, I 
find more or less complete notes of over 2000 cases of syphilis ex- 
tending back over a period of more than twenty years. The larger 
number of these patients came under my care on account of skin- 
lesions, during various periods of the disease, generally after the 
primary sore had disappeared, and in some instances even many 
years thereafter, and not more than one-third of them came on 
account of the local sore, or with its remains still present. 



36 



SYPHILIS INSONTIUM 



The figures, therefore, which are hereafter given fail to accu- 
rately represent the real frequency of syphilis insontium among these 
2000 patients, or even the relative number of extra- genital chancres 
occurring among them ; for, while these latter would commonly 
attract attention and were always noted when present, in the ma- 
jority of the cases of syphilis no record whatever was made either 
of the location or the character of the primary lesion, or of the 
source of infection ; indeed, in very many cases these matters were 
not known positively to the patient or myself. That there were 
many more cases of extra-genital chancres than are here mentioned 
there is not the slightest doubt, while the cases of true syphilis in- 
sontium, especially in women and children (including marital and 
hereditary syphilis), would probably number several hundred. 

However, among these 2000 cases of syphilis notes of extra- 
genital chancres occur in 1 13 instances, or in over 5.5 per cent. , ex- 
cluding a number of cases seen casually, the notes of which are 
not at hand, or were not preserved. In addition to these instances 
of extra-genital chancres there were records of a considerable 
number of primary lesions seen in unusual situations on and about 
the genitals, such as those within the urethra, on the pubis, 
scrotum, etc. ; these are excluded from consideration here, as be- 
longing pretty certainly to the venereal class. 

It will be seen later that in almost all the cases whose history 
is given the lesions were non-venereal in character and innocently 
acquired, and in most of them the nature of the disease was not 
previously suspected : fully one-third of the cases occurred in pri- 
vate practice and among those well to do in life. 



LOCATION OF EXTRA-GENITAL CHANCRES 



37 



These extra-genital chancres affected various localities, as 
shown in the accompanying table : 

TABLE IV. 
Location of Extra-Genital Chancres. 

PERSONAL CASES. 



Location. 


1 

Male. 


Female. 


Total. 


Chancre of the lip, 


20 


30 


50 




' " tonsil, 


8 


7 


15 




' " finger, 


13 


2 


15 




' " breast, . 


— 


7 


7 




' " tongue, 


3 


3 


6 




' " cheek, 


5 


— 


5 




• " eyelid, 


3 


1 


4 




' " chin, 


2 


1 


3 




' " hand, 


I 


1 


2 




' " nose, 


I 


— 






' " ear, 


I 


— 






' " temple, . 


— 


1 






' " neck, . 


— 


1 






' " forearm, . 


I 


— 






1 " sacral region, 


I 


— 




Total 




59 


54 


113 



Of these one hundred and thirteen cases it will be noticed that 
59 were in males and 54 were in females, giving the preponderance 
to the males; this is somewhat remarkable, for it has generally- 
been supposed that extra-genital infection was much more common 
in females than in males. It has been already remarked that 
extra-genital chancres occurred with greater relative frequency in 
venereal clinics among females ; in the present instance the sta- 
tistics are drawn from skin clinics and from private practice in 
diseases of the skin. It would seem, therefore, that practically 
both sexes are about equally liable to this mode of infection. 



38 



SYPHILIS INSONTIUM 



The ages of these patients ranged from three years and ten 
months to 60 years, as shown in the following table, with the ages 
arranged in periods of five years. 

TABLE V. 
Ages of Patients with Extra-Genital Chancres. 



Ages. 


Males. 


Females. 


Total. 


Under 5 years, 


— 


2 


2 


5 to 10 


' . . 


— 


— 


— 


10 " 15 




I 


— 


I 


15 " 20 


• 


I 


7 


3 


20 " 25 




12 


9 


21 


25 " 30 


. 


10 


16 


26 


30 " 35 ' 




12 


8 


20 


35 " 40 ' 


• 


6 


7 


13 


40 " 45 




10 


2 


12 


45 " 50 


• 


.3 


1 


4 


50 "55 ' 




3 


— 


3 


55 " 60 


. 


— 


1 


I 


60 " 65 




1 


1 


2 


Total, 


59 


54 


113 



It will be seen that 80 of the patients, nearly three-quarters of 
the whole number, were between the ages of 20 and 40, the num- 
ber in each five years in this period being nearly the same, the 
largest number, 26, occurring between the ages of 25 and 30. 
This is a time of life when, from the activity of the individual, one 
would naturally be exposed in many ways not so common among 
those in older or younger years. This corresponds also to the 
common experience in regard to syphilis in general: thus, in a 
large number of cases analyzed by the writer some time ago, 53 
per cent, of all cases of syphilis occurred between the ages of 20 
and 35 years. 

As remarked in regard to the table of extra-genital chancres in 
the previous chapter, statistics vary greatly according to the source 



CHANCRE OF THE LIP 39 

from which they are taken, and another group of cases might 
present quite other relationships between the sexes and the ages, 
and would also probably exhibit a different relative proportion of 
chancres in various localities. It will be noticed that the tables 
present no instances of vaccination chancre, nor any where 
syphilis was acquired by circumcision, and contain but a single 
example of the probable communication of syphilis by tattooing ; 
breast chancres are also not very numerous. 

Brief notes of the cases referred to may now be given, and- the 
groups of cases will be considered in the order of the relative 
frequency of the primary lesions in various localities, as seen in 
Table IV. ; for convenience of reference the histories will be 
arranged in the order of the ages of the patients in each group of 
cases. The notes will be given, as far as possible, in the language 
recorded at the time ; but, as many of the patients were seen in 
public practice, and some of them many years ago, there is neces- 
sarily a considerable difference in the fulness and exactness of the 
descriptions given, and in some instances the data found are less 
full and satisfactory than could be desired. 

CHANCRE OF THE LIP. 

This forms, as will be seen, nearly one-half of all the cases, 
namely fifty out of a total of one hundred and thirteen instances of 
extra-genital chancre. This large proportion of lip chancres is 
accounted for both by the relatively greater frequency of extra- 
genital infection in this location, and also by the fact that the cases 
occurred largely in dermatological practice; such lesions, often 
suspected to be epithelioma, would be more likely, therefore to 
present themselves than those about the eye, breast, cavity of the 
mouth, etc. Of these cases 20 were in males, and 30 in females. 
The sore occurred 16 times on the upper lip, 39 times on the 
lower lip, and once at the right labial commisure ; the ulcer was 
situated on the right side of the lip in 13 patients, on the left in 12 
instances, in the middle in 16 cases, and in 9 patients the precise 
location was not stated. 

Case I. Chancre of lower lip. Z. A. , a well developed little 
girl, three years and ten months of age, was brought to my clinic, 
April 13, 1889, with a well defined papular syphilide covering the 
entire body, but somewhat fading, and with mucous patches about, 
the anus. The eruption was evidently not due to hereditary 



40 SYPHILIS INSONTIUM , 

syphilis, and the mother who came with the child was examined 
and questioned and found to be free from syphilis ; two others of 
her children, aged eight years and ten months respectively, were 
examined shortly after and found to be perfectly healthy. 

In searching for the site of infection a well defined chancre 
was found on the lower lip, mostly on its inner surface, extending 
partly on to the vermilion border. The ulcer was about half an 
inch in diameter, nearly round, red, and slightly raw on the 
surface, sharply defined and decidedly hard to the touch. The 
glands beneath the jaw were swollen, and there was immense 
post-cervical adenopathy. The sore had existed for several months 
and had resisted various local applications. The child was under 
observation some little time, during which the eruption disappeared 
and the sore healed very rapidly, under active mercurial treatment. 

The probable source of infection was traced to another child, 
who had sore mouth, and with whom she had played two weeks or 
so previous to the first appearance of the sore on the lip. 

Case II. Chancre of lower lip. Z. B., a little girl, aged \\ 
years, was brought to me on November 14, 1883, on account of an 
obstinate sore on the right side of the lower lip, which had existed 
for 2 or 3 months, and had refused to heal under various treatments : 
a general rash had appeared on the child's body two or three weeks 
previous to her visit, and was still present, it being a most char- 
acteristic erythematous syphilide. The lip was the seat of a some- 
what protruding mass, about half an inch diameter, with a smooth 
surface of a vivid red color, giving forth a glairy secretion ; it was 
somewhat indurated, owing possibly in part to cauterisations 
previously made by those who had seen her, and there was a pain- 
less enlargement of the glands beneath the jaw on that side. 

Her mother, who brought her, had been for six weeks under 
my treatment for an early syphilis, some nine months previous, 
but had neglected her case; and when she returned with the child 
her own mouth was full of mucous patches, she was very hoarse, 
and had still the remains of her papular syphlitic eruption on the 
lower extremities ; there could be no question in regard to the source 
of the infection from the mother, but whether directly from kissing, 
or by means of some mediate object could not be determined. 

Case III. Chancre of lower lip. Miss Z. C, aged 17, applied 
at my clinic at the Post Graduate Medical School, February 10, 
1893, for the treatment of sore lip. 



CHANCRE OF THE LIP 41 

Four weeks previous she had noticed a sore just to the right of 
the centre of the lower lip, which had refused to heal, and increased 
in size and distinctness up to the date of the visit. A week after 
its first appearance the sub-mental gland of the right side began 
swell, and two weeks later the throat became sore, and she also 
began to experience rheumatic pains and malaise. 

The lip was found to present a hard mass, nearly circular, and 
about half an inch in diameter, covered with a dirty crust on its 
outer portion, and moist and exuding within: the glands be- 
neath the chin were swollen, and presented a firm mass : there were 
mucous patches in the throat, but no eruption. 

The origin of the trouble was believed to be from kissing a 
young man with sores in the mouth and an eruption on the face. 

Case IV. Chancre of lower lip. Miss Z. D., aged 18, applied 
for the treatment of a maculo-papular syphilide covering the body, 
head and extremities, including the palms and soles ; it had ex- 
isted four weeks at the time of her visit, October 18, 1890, and 
had been accompanied with headache, malaise, rheumatic pains, 
and sore throat. 

For three months previous she had what she thought a " cold 
sore " on the lower lip, a little to the left of the median line, which 
she had picked from time to time, and which had gradually in- 
creased in size. 

On examination the entire lip was seen to be much swollen, 
and on the left side there was a somewhat raised, hard, crusted 
mass, about three-quarters of an inch in diameter, easily bleeding 
when the crust was removed: the glands beneath the jaw were 
swollen, and mucous patches existed on the lips as well as in the 
throat. 

She thought that the infection came from kissing a lady friend 
who had sore lips. 

Case V. Chancre of lower lip. Mrs. Z. E., aged 19, had 
had a sore on the right side of the lower lip eleven weeks, when 
first seen, April 13, 1887. It began as a "chap " which took the 
appearance of a " cold sore, " and was irritated by biting off the 
crust which continually formed. She had tried to heal it with a 
plaster, but it had steadily increased in size until the time of her 
visit. It then presented a raw surface fully half an inch in 
diameter, involving the width of the vermilion border of the lip, 
partly covered with a crust, and partly bleeding, where this was 



42 SYPHILIS 1NS0NTIUM 

torn off : very little hardness could be felt, but the glands beneath 
the jaw were enlarged. A copious macular syphilide had ap- 
peared two weeks previous, with mucous patches in the mouth. 

No history could be obtained of the manner of infection, but 
as she appeared to be a loose character, it was not difficult to un- 
derstand its occurrence : she was lost sight of after a few visits, 
even before the chancre was fully healed. 

Case VI. Chancre of upper lip. Miss Z. F., aged 19, was sent 
to my clinic by Dr. A. from a neighboring town, on Feb- 
ruary 12, 1890, on account of a sore on the upper lip which 
had proved rebellious to treatment locally applied. -It had first 
appeared as a small crack, near the centre of the upper lip, six 
weeks previously, and had gradually increased in soreness, with 
the formation of a solid mass at the site, until the time of her first 
visit ; for a few weeks it had had a superficially ulcerating surface, 
upon which a thin crust had formed. Two or three weeks after 
its first appearance she had noticed a painless swelling beneath 
the jaw, on the left side, and later some swelling on the right side. 

As the girl denied all possible sources of infection, she was 
left without constitutional treatment for some weeks, when a most 
characteristic papulo-pustular syphilide appeared, covering most 
of the body and extremities. 

Under active mercurial treatment the ulcer healed very rapidly, 
the eruption vanished, and the adenopathy disappeared ; she was 
under observation and treatment for some months, and when last 
seen all active symptoms had ceased, though she still had a red, 
shiny patch on the lip, where the chancre had been. 

No cause for the infection could be discovered, except possibly 
kissing. 

Case VII. Chancre of lower lip. Miss Z. G., aged 19, was 
brought to my office by her fiance, who was under my treatment 
for syphilis of eight months' duration, on August 29, .1887. Her 
eruption began two months previously, and consisted then of a 
somewhat fading, general, small, maculo -papular syphilide, with 
adenopathy. She then had the remains of a chancre situated in 
the centre of the lower lip, which dated back three or four months ; 
it had partly healed, and was then quite superficial ; there were 
also mucous patches in the mouth. 

Very careful inquiry excluded the idea of any other origin of the 
disease than by kissing, and the sore had commenced about three 



CHANCRE OF THE LIP 43 

months previous to her visit, at a time when her lover had 
abundant mucous patches in the mouth. 

Case VIII. Chancre of lower lip. Mr. Z. H., aged 20, an actor, 
on August 27th scratched the lip with his finger-nail, on the site 
of a red blotch left after a cold sore, and to heal it he applied some 
"face paint ;" on September 2d the edge of the lip was cut by a 
barber, but only the patient's own handkerchief was applied to it. 
He then applied some liquid remedy for " barbers' itch," and on 
September 6th the lip began to ulcerate and to crust over, and 
about the same time he noticed some swelling of the glands be- 
neath the jaw. 

When he presented himself for treatment, September 22, 1888, 
there was a circular, protuberant mass, about half an inch in diam- 
eter, covered with a crust, near the centre of the lower lip, en- 
croaching fully one-half on the cutaneous surface below the ver- 
milion border ; the sore was hard at its base, and well defined, but 
with some adjacent inflammation in the lip; the sub-maxillary 
glands were bilaterally enlarged, there was multiple cervical 
adenopathy, and slightly ulcerated mucous patches were seen on 
the tonsils, but no general eruption. Later, the most exquisite 
miliary syphilide appeared. 

The lip chancre proved remarkably rebellious to careful local 
and general treatment, most faithfully carried out, and even four 
months after he was first seen there was still a very distinct, cir- 
cumscribed, firm mass, quite circular in outline, and with a shiny, 
red surface, at the seat of the original sore. 

Case IX. Chancre of lower lip. Mrs. Z. I., aged 20, wife of 
Mr. Z. K. , Case XL, contracted a sore on the right side of the 
lower lip, seven or eight months after marriage, presumably 
from her husband, who was then under treatment for his lip 
chancre and mucous patches of the mouth; he had been cau- 
tioned in regard to the exposure of others, but being of a careless 
and rather dissolute character, he neglected the treatment of his 
case and the precautions for the safety of others. Following the 
chancre of the lip she had three miscarriages, at 7, 8, and $\ 
months respectively, and when seen from time to time had late 
tubercular and gummy lesions upon the soles and about the right 
knee. The scar of the initial lesion on the lip was still present, 
even two years after infection. 

Case X. Chancre of right commisure of mouth. Miss Z. J., 



44 SYPHILIS INSONTIUM 

aged 20, an estimable young lady, had what was thought to be a 
"cold sore " at the right angle of the mouth, four weeks before 
her visit, June 22, 1893. This refused to heal and increased in 
size, was soon accompanied by swelling of the glands beneath the 
jaw, and two weeks before her visit a pretty general macular erup- 
tion appeared. During most of the time she had had much malaise, 
and for the last two or three weeks the throat had been 
sore. 

On examination there was a large, indurated mass occupying 
the right angle of the mouth, protudmg externally and extending 
back half an inch or more on the mucous membrane. The outer 
portion was irregularly oval in shape, one-half by three-quarters 
of an inch in diameter: it was raised above the surface, with toler- 
ably sharply defined edges, and was distinctly hard. The surface 
was superficially eroded over its greatest part, and gave forth a 
glairy secretion. On the mucous surface the protuding mass could 
not be told from a hypertrophic mucous patch. The eruption and 
sore throat were characteristically syphilitic. 

The source of contagion was believed to be from a young man 
to whom she had been engaged, who had a sore mouth. 

Case XI. Chancre of lower lip. Z. K., a tailor, aged 21, hus- 
band of the above mentioned patient (Case IX.), was brought to 
my consulting room at the New York Hospital by a confrere, for 
diagnosis in regard to a rebellious sore in the centre of the lower 
lip, which had resisted local measures for several weeks. The sore 
presented the usual appearances already described, and was 
diagnosed a lip chancre, but as it did not give him much trouble 
he treated it rather lightly, and subsequently neglected treatment, 
until more annoying symptoms presented themselves; at the time 
when first seen, he had a swelling beneath the jaw, but, as he had 
been subject to enlarged glands in this location, this also caused 
him no uneasiness. 

He afterwards returned for treatment, mainly because of his 
sore mouth, with malaise and loss of flesh, he having lost twenty- 
four pounds in three months; he then was transferred to my 
service, August 10, 1887. On stripping he was found to be cov- 
ered with a fine maculo-papular syphilide, of which he seemed to 
be hardly conscious ; he had also double inguinal adenopathy and 
a considerable number of mucous patches on the tongue and buccal 
cavity. 



CHANCRE OF THE LIP 45 

The lip chancre was supposed to have been contracted from a 
prostitute, with whom he had associated, but nothing definite 
could be learned ; he had not seen her since. The disease ran 
rather a severe course, with abundant and persistent mouth lesions, 
and he still came for occasional treatment, even up to within a few 
months of the time of present writing. 

Case XII. Chancre of the lower lip. Mr. Z. L., aged 21, came 
to the New York Hospital November 12, 1892, on account of 
an ulcer of the lip, and a general eruption, which had just ap- 
peared. 

He had first noticed a soreness of the lower lip on the left side, 
about three months previous : a month later the sore took on a 
different appearance, and assumed a definite outline, more or less 
circular and protuding from the lip. The eruption had appeared 
a couple of weeks before his visit. 

On examination there was an inflamed mass on the lower lip, 
in about the middle of the left half, extending from the edge of the 
lip well into the mouth, measuring one-half by three-quarters of an 
inch in diameter. The surface was moderately raised, but the 
margin not very sharply denned : there was not much induration, 
although the mass was firm to the feel. On the free portion of 
the vermilion border it was covered with a brownish adherent 
crust ; the inner portion was moist and succulent, bleeding easily. 
The sub-maxillary glands of that side were greatly enlarged, and 
somewhat so on the opposite side ; there was some general adeno- 
pathy. The penis and genital region were carefully examined, 
and there was no trace of a chancre there or elsewhere, except on 
the lip. The general eruption was in the papular form, and very 
prominent on the face and head. 

No definite clue could be obtained as to the source of infection, 
but he charged it to cigars, as the man from whom he bought 
them had active syphilis, and was very careless in handling them. 

Case XIII. Chancre of upper lip. Miss Z. M., aged 22, was 
first seen in November, 1879. The sore, which was on the left 
side of the upper lip, was first noticed four weeks before the visit, 
as two small "water-blisters," which soon became crusted, and 
the lip very sore; the glands beneath the jaw swelled two weeks 
later. When first seen, the sore was covered with a dark, firmly 
adherent crust, but at the second visit the crust had been removed, 
revealing a red, fleshy, irregular sore nearly an inch in diameter, 



46 SYPHILIS INSONTIUM 

without marked induration ; the surface was covered with a dried, 
glairy secretion, with a little pus in one point. One week later, 
the swelling" of the glands was enormous, while the sore was heal- 
ing rapidly from the sides, under mixed treatment. Three weeks 
from the time of her first visit, an abundant roseolous eruption 
appeared, with mucous patches in the throat : a week later it was 
recorded that the inflammatory element on the lip had largely 
subsided, and that the chancre then presented some induration. 

The patient charged her disease to using the same cup with 
another girl, who had also a sore on the lip ; confrontation could 
not be obtained. 

Case XIV.. Chancre of lower lip. Mrs. Z. N., aged 22, seen 
first April 12, 1882, charged her chancre on the lower lip to her 
husband. It had existed four and one-half months, and when 
seen was almost healed, presenting a smooth, shiny surface, with 
some induration: it had been ulcerated for three months, and had 
healed under anti-syphilitic treatment at other hands. She subse- 
quently had mucous patches, periosteal tenderness, aphonia, etc. 

Case XV! Chancre of upper lip. Miss Z. O. , a domestic, aged 
22, presented herself August 5, 1889, with a great swelling of 
the upper lip, which had originated from a "cold sore " five weeks 
previously : the little abrasion, she stated, had gotten worse and 
become harder after having kissed a friend, a few weeks before 
her visit to the §kin and Cancer Hospital. 

Wh eh first seen there could be made out very distinctly, on 
the inner surface of the upper lip, to the left of the median line, an 
ulcer about three quarters of an inch in diameter, with quite sharply 
limited 'eolges, and deeply infiltrated; there was sub-mental and 
cervical adenopathy, more marked on the left side. There was 
then no eruption, no headache, nor other sign of constitutional 
infection. The patient entered the Hospital, and under the free 
local use of calomel the inflammatory oedema of the lip rapidly 
subsided!, and the sore became more distinct, and within three 
weeks the lip was nearly well. Five weeks from her first visit, a 
maculo-papular eruption appeared, which yielded soon, but again a 
grouped papular lesion appeared two months later, which in turn 
disappeared under constitutional treatment. 

Case XVl. Chancre of lower lip. Mrs. Z. P., aged 24, whose 
husband was subsequently under my care for syphilis, and died 
(under other hands) from probable syphilitic disease of the kidney, 



CHANCRE OF THE LIP 47 

gives a most clear history of chancre in the middle of the lower 
lip, occuring just after marriage, and almost seven years before 
she came under my personal care. The chancre of the lip was 
probably recognized at the time by a prominent physician in 
Chicago, who treated it accordingly ; but it was still followed by 
early syphilitic symptoms, a general eruption, mucous lesions at 
the vulva and anus, loss of hair, etc. ; I afterwards treated her for 
nodes in various localities and a papulo-tubercular syphilide. 

The case is peculiarly interesting from the fact that her 
husband had been previously engaged to another patient of mine, 
whose case will be given later (Case LX. ) to whom he had com. 
municated a chancre of the tonsil: the date of the active stage of 
syphilis in the man, who at the time had many mouth lesions, 
corresponds exactly with the date of infection of his two fiancees, 
who developed their chancres not very long after each other. The 
occurrence of the syphilis in the other case, to be mentioned later, 
was the cause of the breaking of the engagement and subsequent 
attachment to this young lady, whom he married, and infected on 
the lip. 

Case XVII. Chancre of lower lip. Mr. Z. Q., aged 24, first 
noticed a swelling of the right sub-maxillary gland, in the latter 
part of May, 1883, and about the same time he found a crack in 
the lower lip, near the right angle of the mouth. Five or six 
weeks later this was followed by a general eruption, which lasted 
until the date of his visit, August 25, 1883. He had had inter- 
course with but one woman during the year, and denied ever 
having any sores on the genitals, which were examined and found 
to be free. The chancre on the lip was still present and a general 
maculo-papular syphilide, together with mucous patches in the 
fauces. 

The case was only seen once in consultation, and no record was 
made of any special mode of infection. 

Case XVIII. Chancre of upper lip. Mr. Z. R., aged 24, applied 
August 5, 1 89 1, at the New York Skin and Cancer Hospital, on 
account of a sore lip. 

On examination there was on the upper lip, just to the left of 
the middle line, a circular, protruding mass, fully three-quarters 
of an inch in diameter, extending from the cutaneous edge, across 
the vermilion portion, and well into the mouth : the whole lip was 
considerably swollen, and the mass itself was very distinctly hard 



48 SYPHILIS INSONTIUM 

and resisting. The exposed portion was covered with a bloody 
crust, that within the mouth was raw and exuding, bleeding very 
easily. There was very general adenopathy about the head, the 
left sub-maxillary glands being especially enlarged ; the throat was 
much inflamed : a very general and well marked maculo-papular 
eruption existed about the mouth, chin, nose and forehead, and 
also very generally on the body and upper extremities. 

He stated that a month previous a crack in the lip became sore, 
and this increased in severity, under various treatments, until the 
date of his visit. He could give no positive idea as to the mode of 
infection, but as he was a bartender, and in the habit of smoking 
the pipes of others, and also of kissing girls of questionable char- 
acter, it is easy to account for the infection. 

Case XIX. Chancre of lower lip. Mrs. Z. S., aged 25, was 
under treatment for a syphilitic gumma of the tongue, when seen 
in consultation October 13, 1879. She gave a clear history of a 
chancre of the left side of the lower lip, four years previously, 
followed by sore throat, etc. Her husband had died two years 
before her visit, of some lung disease, and was said to have had 
venereal disease severely. 

Case XX. Chancre of lower lip. Miss Z. T., aged 25, first 
noticed a small tender point on the right side of the lower lip, 
toward the end of November, 1889: this she scratched, and it 
gradually got worse until she applied for treatment, January 25, 
1890. The sub-maxillary glands had then been enlarged for two 
or three weeks. 

When first seen, there was an oval, slightly elevated patch on 
the lower lip, to the right of the median line, something about one- 
half inch by three-quarters in diameter ; it was crusted over and, 
presented a clearly defined solidity and hardness. A general 
maculo-papular syphilide had just appeared over the body and 
limbs, with mucous patches in the throat, and cervical adenopathy. 

No cause for the infection could be learned. 

Case XXI. Chancre of lower lip. Miss Z. U., aged 25, seen on 
March 10, 1879, had had a sore on the lower lip for five weeks 
previous to the date of her visit. It was half and inch in diameter, 
nearly circular, flat, superficially ulcerated, of a greyish color, 
with well-defined edges, and exhibited a parchment-like induration : 
it had never been cauterized ; there was sub-maxillary adenopathy. 

No source of infection could be traced. 



CHANCRE OF THE LIP 49 

Case XXII. Chancre of lower lip. Mr. Z. V. , a painter, aged 
25, applied for treatment March 1, 1882, with a well-developed 
chancre of the lower lip. No notes of this case are accessible, and 
no further data can be given than the above record, taken from 
the books of the Institution where the case was observed. 

Case XXIII. Chancre of upper lip. Mr. Z. W. , aged 25, had 
an initial lesion on the upper lip, which had existed four weeks, 
when he applied for treatment, June 30, 1886: the sore was seated 
partly on the cutaneous and partly on the mucous surface. He 
had connection last on April 1, when he acquired a gonorrhoea. 
A general maculo-papular eruption appeared soon after his first 
visit. No cause of infection discovered. 

Case XXIV. Chancre of upper lip. Miss Z. X., a waitress, 
aged 26, was admitted to the Skin and Cancer Hospital, February 
7, 1891, on account of a peculiar sore situated on the fleshy part 
of the upper lip, directly beneath the septum nasi. No satisfactory 
history could be obtained in regard to its cause or first appearance ; 
it had been there some weeks, increasing from a small abrasion. 
The sore was sharply defined, slightly crusted over, and when this 
was removed the surface was slightly moist and depressed : it was 
not over one quarter of an inch broad, by three-eights in vertical 
diameter, and presented a certain amount of hardness. 

As the sore was suspected to be a chancre, she was kept under 
observation, without treatment, and at the end of two weeks a 
macular-eruption appeared on the chest, and extended later to the 
extremities; it afterwards became somewhat papular. She was 
kept long in the Hospital under treatment, as she had planned an 
early marriage, which it was desirable to defer as long as possible. 
The primary sore soon healed, but in spite of active treatment 
she presented signs of constitutional infection for some time. 

Case XXV. Chancre of lower lip. Mr. Z. Y., aged 26, a cigar- 
maker, was first seen August 31, 1881. He gave rather an 
unsatisfactory history as to the first appearance of the sore on his 
lip, which had lasted some little time ; he had had connection six 
weeks previous, and remembered kissing a woman of loose char- 
acter, and using her handkerchief. When first seen, he had a 
distinctly indurated sore in the center of the lower lip, circular, 
and about the size of a ten-cent piece. The sore was of a yellowish 
color, secreted but little, and gave scarcely any pain. There was 
considerable swelling of the sub-lingual and sub-maxillary glands. 



50 SYPHILIS INSONTIUM 

This patient was under observation and treatment for several 
years, off and on. and was last seen April 5, 1884. He went 
through as severe a course of syphilis as is often seen, with various 
skin-lesions, hoarseness, and abundant, persistent mucous patches, 
almost to the last. 

Case XXVI. Chancre of upper lip. Mrs. Z. Z. , aged 26, applied 
for treatment at the Skin and Cancer Hospital, January 28, 1887 : 
the patient had been married five years, and lost her husband two 
months previous to her visit. It was learned that at about the time 
of her husband's death she had had much to do with a female 
friend (Mrs. V. B., case CVL), also under treatment at the Hos- 
pital, who had a chancre of the back of the hand, and mucous 
patches in the mouth, — whom she kissed repeatedly. About a 
month after this, the lesion on the lip began to develop and in- 
creased up to the time of observation. 

When first seen there was a sore, about three-quarters of an 
inch, in diameter, on the left side of the upper lip, circular, ele- 
vated, and with a distinctly sclerotic base, its surf ace being uneven 
and of a greyish-yellow color: the sub-maxillary glands on the left 
side were enlarged, and she had severe headache. Two weeks 
later a macular syphilide appeared, and subsequently mucous 
patches in the mouth. By May 20th the chancre had completely 
healed, but she had later signs of constitutional syphilis. 

Case XXVII. Chancre of mucous surface, centre of upper lip. Mr. 
Y. A., aged 27, had a sore on the inner surface of the upper lip 
about three months previous to his visit, May 10, 1893, which was 
slow in healing, and was soon followed by enlargement of the 
gland, beneath the right jaw, and sore throat A few weeks after 
the sore became prominent he had a general macular eruption: 
the eruption disappeared, and the sore healed under the very active 
and efficient treatment which he had received from his physician. 
He was sent to me because of the fall of hair, which had lately 
been coming out in a patchy manner. 

When seen the sore on the lip had quite healed, but there was 
still glandular enlargement beneath the right jaw: there was no 
trace of a primary sore on the penis, nor had he had any lesion 
there. The hair was thin, and falling irregularly in patches, as 
seen in syphilis, but he exhibited then no other sign of the disease, 
except the sub-maxillary adenopathy. 

He charged the sore to kissing, but he was a smoker. 



CHANCRE OF THE LIP 51 

Case XXVIII. Chancre of lower lip. Miss Y. B., a seamstress, 
aged 28, came to the Skin and Cancer Hospital April 6, 1888, for 
treatment of a general, fine, papular eruption, grouped in places, 
and situated principally on the back, thighs and legs, with ulcer- 
ative mucous patches on the tonsils. 

The disease began some months previously, with soreness of the 
throat, pain in the head and general malaise, shortly followed by 
alopecia and a general eruption. The history of the case is very 
imperfect, but points to the beginning of the disease with an ulcer- 
ation on the lower lip, near the centre of which there were the 
remains of a chancre, in the form of a well-defined purplish scar. 

Nothing could be learned as to the real beginning of the sore 
or of the mode of infection. 

Case XXIX. Chancre of lower lip. Mrs. Y. C, aged 29, a lady 
of position, first noticed a swelling beneath the jaw on the left side 
of the face, in June, 1875, two months before her marriage ; at the 
same time there was a little sore on the left side of the lower lip, 
which then hardly attracted attention, but which afterwards became 
indurated and proved rebellious to all efforts to heal it. When first 
seen, January 8, 1876, seven months after its first appearance, 
there were still some remains of the chancre, an induration being 
readily felt just beneath the border of the lip, on the inside, about 
midway from the centre to the angle of the mouth ; the surface 
was entirely healed over. 

Two or three months after the lump beneath the jaw was first 
noticed, there appeared a general rash, which also remained par- 
tially visible at the time of the visit ; the nature of the disease had 
been recognized, or rather suspected, and she had taken iodide of 
potassium, iodide of iron, and a little mercury, which, however, was 
said to have made the eruption worse. Her syphilis ran rather 
a severe course, with recurrent eruptions. She was five months 
pregnant when first seen and had a still-born child at full term ; 
but under active treatment she shortly bore a living child which 
remained perfectly healthy, and was over two years old when the 
patient was last seen, December 23, 1879. 

No possible cause for the infection was discovered : her hus- 
band was said to be healthy and pure, and certainly had no visible 
signs of syphilis. 

Case XXX. Chancre of upper lip. Mrs. Y. D., aged 29, of 
doubtful character, first noticed a sore on the middle of the upper 



52 SYPHILIS INSONTIUM 

lip, four weeks before her visit, March 7, 1891 : there was a small 
scab on it which she pulled off, making it to bleed. 

The sore on the lip presented a very characteristic appearance, 
being raised, moderately crusted, and surrounded by considerable 
boggy inflammation. She had sub-mental and other adenopathy, 
and developed a very characteristic macular syphilide. After 
a month's diligent treatment, including mercurial plaster to the 
sore, she had still a protruding, moderately hard mass in the centre 
of the upper lip, which, however, when last seen, very recently, 
had completely healed over, leaving a smooth, red, glossy surface. 

She attributed the sore lip to smoking a cigarette, which, how- 
ever, was a fresh one, from a package, and she had never smoked 
one from the lips of another person; but she also states that she 
was kissed afterwards by some one who bit the lip, but does not 
know of the existence of a sore mouth in that person or others of 
her acquaintance. 

Case XXXI. Chancre of lower lip. Mrs. Y. E., aged 30, 
presented herself October 1, 1886, with the history of having 
acquired syphilis two-and-a-half years previously : the initial lesion 
was located on the lower lip in the middle line, where there was 
still a distinct cicatrix visible, with some induration. At the time 
of first observation she had a late papular syphilide on the palms 
and soles, headache, sore throat, and mucous patches on the 
tongue. 

No source of the infection could be determined. The patient 
also brought her little girl with her, eighteen months old, but 
small for her age, also with a palmar syphilide. 

Case XXXII. Chancre of upper lip. Mr. Y. F., a clerk, aged 
30, was admitted to the Skin and Cancer Hospital April 28, 1890, 
on account of an ulcer on the middle of the upper lip. No definite 
history could he obtained in regard to the mode of its development, 
except that the sore had begun to attract his attention about the 
close of the preceding February, and had persisted, in spite of 
ordinary treatment, until the date of his admission. 

The sore presented the usual appearances of a single, well- 
defined, almost round ulcer, crusting over easily, and bleeding 
when the crust was removed ; he had mucous patches in the mouth 
and throat. 

Under active mixed treatment, and chlorate of potash mouth- 
wash, the ulcer improved rapidly, so that in three weeks it was 



CHANCRE OF THE LIE 53 

entirely healed, and the mucous patches gone, and he left the 
Hospital. He afterwards returned to the out-patient department 
with recurrent mucous patches, adenopathy, and periosteal trouble. 

Nothing could be learned in regard to the mode in which the 
chancre was acquired, but as he was dissipated, and subsequently 
returned with gonorrhoea, it is easy to understand that the lip 
infection took place in promiscuous intercourse. 

Case XXXIII. Chancre of lower lip. Mrs. Y. G., aged 30, 
came to my office October 24, 1891, for the treatment of a large 
mass of gummy syphilide, covering an area of nearly two inches 
in either diameter, on the chin : this had existed over a year, and 
had been treated as lupus, and showed already much scar tissue. 
She was a very intelligent lady, and as the diagnosis of syphilis 
had previously been considered and rejected, the matter was freely 
discussed ; it was found that her husband had not had the disease, 
and no cause for the infection had been discovered. 

On careful investigation it was found that ten years previously, 
and three years before her marriage, a sore had appeared to the 
right of the middle line on the lower lip, which had lasted at least 
two months, and was accompanied with greatly swollen glands 
beneath the jaw on that side ; she was then feeling very miserably, 
and soon had a general eruption, and later some scattered tuber, 
cular lesions. The scar of the original lip chancre still remains 
very plain, it being almost circular, white, and slightly depressed, 
and nearly half an inch in diameter, situated near the center of 
the vermilion border of the lower lip. 

No cause for infection could be ascertained, but she was living 
then in a mining region in a Western State, and undoubtedly 
acquired it by kissing. 

The lesion on the chin yielded with wonderful rapidity to 
mixed treatment. 

Case XXXIV. Chancre of lower lip. Mr. Y. H., aged 33, had 
been occasionally at my office for psoriasis, for several years. On 
May 7, 1887, he noticed a sore spot on the right side of the lower 
lip, just as he was leaving on the steamer for Europe. On May 23, 
1887, he saw a physician of eminence in Paris, who diagnosed a 
chancre, and gave him proto-iodide of mercury in pills, half a grain 
morning and evening. When seen, on his return, July 27, 1887, 
there was a hard, red, shining, button-like mass in the lower lip, 
depressed in the centre, and slightly protruding from the level of 



54 SYPHILIS INSONTIUM 

the surface ; the glands tinder that side of the jaw were moderately 
swollen. The entire body was covered with a maculo-papular 
eruption, intermingled with patches of his old psoriasis; he had 
much general adenopathy and some mucous trouble. 

He knew of no special means whereby the sore had been ac- 
quired. 

Case XXXV. Chancre of upper lip. Y. I. , a physician, $$ years of 
age, noticed a sore on the left side of the upper lip about six weeks 
prior to his visit, October 26, 1877. This failed to heal, and, about 
two weeks later, the right side of the upper lip also became sore, 
and both remained in this condition until his visit, the nature of 
the difficulty not being recognized. When first seen, the left side 
of the lip attracted attention by the presence of a clean-looking 
ulceration, very red, and giving off a sticky secretion; the sore 
was decidedly hard on palpation, and was half an inch long by one- 
third of an inch broad. On the right side there was another lesion 
of somewhat the same size and appearance, from which a white 
patch ran to the corner of the mouth. The glands beneath the 
jaw were slightly enlarged and painful. There was already a 
macular syphilide developing on the arms and back. For the past 
two weeks he had been feeling badly, with aching pains, and had 
lost flesh. 

The diagnosis of chancre of the lip was made, and shortly 
after his visit he was seen by another physician in this city, 
especially acquainted with this class of affections, and the same 
diagnosis was made independently. 

The only possible suggestion in regard to the mode in which 
the infection had been acquired, was that it came through the me- 
dium of cigars, he being an excessive smoker, and being conscious 
of carrying the cigar just where the sore was first noticed. About 
the same time when the case was observed, a case had been re- 
ported in Connecticut, where an operative in a cigar factory had 
for some time been rolling and moistening cigars on the lips, 
which were the seat of abundant mucous patches. 

The patient, who was a very intelligent practitioner from a 
large town in Connecticut, was much interested in endeavoring to 
discover the source of the infection of the sore on his 1 ip, and as 
he had been smoking Connecticut cigars very largely, we were 
quite satisfied that it probably occurred in the manner mentioned ; 
this seems all the more probable in view of the very similar case 



CHANCRE OF THE LIP 55 

narrated later (Dr. Y. R., Case XLIV.), and also in consideration 
of the incident there mentioned, in regard to another syphilitic 
cigar-maker, who finished cigars with the lips and tongue covered 
with mucous patches, until obliged to desist, from the pain occa- 
sioned thereby. 

Absolutely no other source of infection could be discovered, 
although we devoted much time and pains to the discovery. 

Case XXXVI. Chancre of upper lip. Mr. Y. J., aged 33, had 
noticed a sore on the left side of the upper lip, near the angle of 
the mouth, about eighteen months previous to his first visit ; he 
could not trace the infection, but had been greatly exposed, and 
had drank pretty heavily. The sore persisted for something over 
a month, and was shortly followed by mucous patches, and occa- 
sionally by later eruptions and nodes : but the disease was held well 
in check by treatment. 

Case XXXVII. Chancre of lower lip. Mr. Y. K. , aged 34, 
came to me April 23, 18 £7, for the treatment of a scaly eruption 
of the penis, with some maculo-papular lesions scattered over the 
chest. On searching for the primary lesion a sore was discovered 
on the inner side of the lower lip, on the right side, which had ex- 
isted for six weeks ; the following history was then elicited : 

About March 1, he had noticed a fissure in the lip, which he 
attributed to smoking cigarettes; on February 27 or 28, he had 
intimate relations with a prostitute, and about March 15 he had 
noticed the lip-fissure to be more of a sore, and on March 23 he 
had some adenopathy beneath the jaw; this was thought to be 
mumps and was poulticed. There was no sore on the penis, nor 
elsewhere; the syphilis ran a mild course. 

Case XXXVIII. Chancre of lower lip. Mrs. Y. L., aged 36, 
had been under my treatment for another difficulty, when, on 
February 12, 1880, she presented herself with a scattered papular 
syphilide with some mucous patches, and a sore on the lower lip 
which had existed for two months. It was about one third of 
an inch in diameter, presenting the usual appearance of primary 
lesions in this locality, and with swelling of the glands beneath 
the jaw. Her husband was of rather loose character, and it was 
supposed that she acquired the disease from him. 

Case XXXIX. Chancre of tipper lip. Mrs. Y. M., a trained 
nurse, aged 36, was sent to my office by a physician in a neighbor- 
ing city, March 26, 1891; she gave the following history: On 



56 SYPHILIS INSONTIUM 

January 12, she came from nursing a private case, and at that time 
she is sure the lip was healthy. But three days later, as the menses 
came on, the lip became sore, like a "cold sore," and on January 
19, she went to nurse a bad case of scarlet fever, for six weeks. 
The sore healed, apparently, but on February 15, with the recur- 
rence of the menses, the lip again became sore and has remained 
so since. The ulcer was treated with home remedies, and court- 
plaster applied, beneath which the sore increased very rapidly, 
and had been about in the condition seen, for two weeks. 

When first observed there was a prominent, round mass, about 
half an inch in diameter, on the upper lip, just to the right of the 
median line ; the surface was crusted, but on the removal of the 
crust a raw, pinkish, smooth surface was presented, bleeding 
easily, and quite solid on pressure ; the sub-mental glands were 
enlarged. I subsequently learned that the sore had been already 
diagnosed as a chancre by a gentleman of this city well acquainted 
with this branch. 

No cause of the infection could be learned ; she claimed not to 
have had anything to do with anyone with sore lips or mouth, 
and was inclined to ascribe it to cigarettes which she had smoked 
between the 3d and 6th of February. 

Case XL. Chancre of lower lip. Mr. Y. N., aged 37, a married 
gentleman, with five healthy children, was sent to me, by his phy- 
sician, with a sore on the right side of the lower lip, November 20, 
1884. The sore was almost circular, three-eighths of an inch in 
diameter, slightly raised, with a hard margin posteriorly; the 
surface was brilliant red, moist, and bled easily. He had some 
papulo-squamous syphilitic eruption about the body and limbs. 
He stated that he had first noticed the sore some six months be- 
fore, and that it had never been treated ; the eruption had been 
supposed to be eczematous, as his mother had had " salt rheum." 
Anti-syphilitic treatment was advised, but two full months later 
his physician stated that the sore was still present on the lip. 

No satisfactory account could be learned as to the development 
of the sore, but he had been somewhat of a drinker, and had 
smoked greatly, up to two or three weeks prior to his visit. 

Case XLI. Cha?icre of upper lip. Mrs. Y. O. , aged 37, came 
to the Skin and Cancer Hospital, November 6, 1891, for the treat- 
ment of a sore lip, which was accompanied with soreness of the 
throat. The sore had been present for two months or more, and 






CHANCRE OF THE LIP 57 

had increased from a small point, until it was about half an inch in 
diameter, presenting the usual appearance of a red, glazed surface, 
giving off a sticky secretion. 

She stated that she had had an eruption, beginning a month or so 
before her visit, but there was little then to be seen ; she had, how- 
ever, mucous patches in the throat and on the tongue. Xo history 
of infection could be obtained. 

Case XLII. Chancre of lower lip. Mr. Y. P., aged 38, a very 
intelligent man, occupied in electrical work, applied at the New 
York Hospital, on November 29, 1890, for the treatment of a sore 
lip which had refused to heal with local measures. Thinking it 
to be epithelioma, he had seen some surgeons of eminence, but 
they, apparently recognizing its nature, had refused to operate. 

The history was, that he had had a crack near the centre of 
the lower lip for four years, off and on, worse in winter and 
almost or quite healing in warmer weather. A couple of months 
or so before his visit, he had noticed a change in the character 
of the sore place, it hardening up, and assuming more the char- 
acter of a definite ulcer, giving off a sticky secretion; a week 
or so before his visit he had begun to have a general eruption. 

When first seen there was a well-defined, round ulcer, pro- 
truding from the surface of the lip, about five-eighths of an inch 
in diameter, the surface a little depressed and covered with a 
crust; the ulcer was decidedly indurated. He had a very profuse 
papulo-squamous syphilide over the body, face, and extremities, 
and iritis of the right eye; he had most intense cephalalgia, which 
had prevented him from sleeping for several nights. 

Under very active treatment the ulcer improved rapidly, the 
eruption faded, and the iritis ceased, though the latter returned 
later. 

The probable mode of infection was very interesting. In test- 
ing electrical currents with the galvanometer he was accustomed 
to put a copper rod frequently in the mouth ; and also in making 
entries he was in the habit of likewise holding a pencil between 
the lips. Working at the same occupation with him were a num- 
ber of men whom he knew to be syphilitic, and they would often 
use the same copper rod before and after him, placing it between 
the lips, and frequently use the same pencil in common ; it 
seemed, therefore, most highly probable that on one or the other 
of these the virus was conveyed to the crack on his lip, at or soon 



58 SYPHILIS INSONTIUM 

before the time when he noticed a change in its character. He 
was a married man, with three children, and had never been 
exposed in sexual intercourse. 

Case XLIII. Chancre of lower lip. Mrs. Y. Q., aged 39, had a 
chancre of the lower lip which lasted three or four months. Her 
husband died of what appeared to be syphilitic paralysis. She 
had afterwards a tubercular syphilide, and gummy, ulcerative 
tumors ; the notes of the case, which was one of the public cases, 
are imperfect. 

Case XLIV. Chancre of lower lip. Y. R. , aged 40, a physi- 
cian of great intelligence, stated that for ten or fifteen years he 
had had a fissure of the lip, which at times proved very trouble- 
some, and again would remain healed for weeks. Six weeks 
before his first visit, he noticed that the fissure discharged a 
serum, which he had to wipe off frequently; two weeks later the 
glands beneath the right angle of the lower jaw became enlarged, 
and swelling of other glands followed later. 

Soon after the changed character of the fissure occurred, he 
suspected infection, and cauterized the spot with chromic acid, 
100 grains to the ounce; a few days later he cauterized it with 
nitric acid and commenced taking -^ of a grain of bichloride of 
mercury, with four grains of iodide of potassium three times daily. 
He had made no local application since the nitric acid; the ulcer 
became greatly irritated and increased in size after this. He then 
saw a number of physicians who failed to recognize the syphilitic 
character of the sore, which was covered with a hard, glutinous 
scab, and secreted freely beneath it ; at the advice of friends the 
sore was again cauterized with nitric acid daily for six days, and 
the an ti- syphilitic treatment stopped, but the latter was soon 
resumed. At the end of the cauterization the sore had reached 
its fullest size, the lip was greatly swollen, the ulcer was the size 
of the thumbnail, and the glands under the right jaw were as 
large as a goose-egg; one week after returning to the mixed treat- 
ment the ulcer began to close at the edges. About the time the 
lip began to heal, and about ten days before his visit, a copious 
eruption appeared ; first on the scalp, then on the forehead, face, 
and hands, and soon it covered the entire body. 

When first seen, July 4, 1879, the eruption was in full bloom, 
and quite unmistakably syphilitic. On the lower lip, just to the 
right of the median line, a circular ulceration appeared, half an 



CHANCRE OF THE LIP 59 

inch in diameter, with a bleeding, granular centre and healed 
margin, which was very sharply defined; there was very little 
hardness, and but little swelling of the lip; the glands beneath 
the jaw were still enlarged. 

In searching for the mode of infection, every possible element 
was gone into, and no direct source could be determined posi- 
tively ; the doctor had not been directly exposed in any way, had 
certainly not been with any suspicious characters. 

But it was learned that some three months previous to the 
visit, he had treated a patient with sores on the penis, and this 
patient, who was a cigar-maker, had brought him cigars from 
time to time, which he had smoked ; he thought that he had used 
a cigarholder, but was not positive. Remembering the case previ- 
ously alluded to (Dr. Y. I., Case XXXV.) where in another physi- 
cian the infection was attributed to cigars, and having just had 
under my care a cigarmaker with syphilis, who acknowledged to 
rolling the ends of the cigars on his lips, until the pain from his 
mucous patches caused him to desist and seek treatment, it 
seemed highly probable that in this instance, also, the cigars had 
become infected, either by the patient or others, and that from 
them the poison had been communicated to the lip. 

Case XLV. Chancre of lower lip. Mrs. Y. S., a widow, aged 
40, had always been in perfect health until July, 1882, when she 
had malaise, fever, and shooting pains, and, a few weeks later, 
deafness and sore throat. She had had a sore on the lip, which 
had been unnoticed until there occurred a swelling of the sub- 
lingual glands on the left side, which was shortly followed by an 
eruption. 

When first seen, some three months after the occurrence of 
the first symptoms, there was found on the lower lip, about the 
middle of the left half, a slightly protruding, glazed mass, about 
the size of the little finger-nail, presenting a cartilaginous hard- 
ness ; upon the face, forehead, and chin there was already a grouped 
papular eruption of characteristic appearance. There was also a 
pretty sharp iritis of the left eye and quite general adenopathy. 

No source of the infection could be found. 

Case XLVI. Chancre of lower lip. Mr. Y. T. , a gentleman of some- 
what free habits, aged 45, gives a very clear history of having had 
a chancre of the lower lip, seven years before he came under ob- 
servation : this was followed very shortly by a general eruption, 



60 SYPHILIS INSONTIUM 

and iritis which was recognized as syphilitic by a prominent ocu- 
list of this city; he then suffered from various later lesions, off 
and on, up to the time when first seen, April 6, 1880. At that 
time the scar of the chancre was plainly visible on the low T er lip. 

In searching for a cause of the lesion on the lip, it was found 
that he might have acquired it in kissing, as he was much exposed 
about that time: but it was also discovered that he had been a 
great smoker, and had always bitten off the cigars, and in smoking 
had been accustomed to rest the cigar just where the sore had 
been, on the lip; so that this might be another possible case where 
the poison was conveyed by means of cigars. 

Case XLVII. Chancre of upper lip. Mrs. Y. U., a widow, 
aged 47, with five children, first noticed a sore on the left side of 
the upper lip about the beginning of August, 1888; this grew 
larger, and became harder, and ulcerated, and, about a month 
after its first appearance, the sub-maxillary glands on the left side 
became enlarged. 

When first seen, the ulcer had healed, leaving a dark-red scar 
nearly an inch in diameter ; there was then general adenitis, sore 
throat, alopecia, and headache, together with a small, grouped 
papular eruption especially on the forearms, which she stated was 
the first cutaneous manifestation of the disease. 

No clue could be obtained in regard to the source of infection. 

Case XLVIII. Chancre of lower lip. Mr. Y. V., aged 51, a 
miner, came from California to be treated for supposed cancer of 
the lip, in the Skin and Cancer Hospital, January 2, 1889. The 
disease had begun six weeks previously, shortly after a blow upon 
the mouth, whereby the lip was cut by the teeth. The lip began 
to harden in about a week, and ten days later he noticed swelling 
of the sub-maxillary glands: the sore had been cauterized repeat- 
edly, and the lip became greatly swollen and inflamed. 

When he first came under observation, the entire lower lip was 
greatly inflamed, and protruded considerably, rendering drinking 
and talking difficult and painful. Closer examination showed on 
the inner, central portion of the lower lip, a large, hard mass, a 
little over an inch in transverse diameter, and occupying the inner 
surface almost to the gum, and extending on to half of the ver- 
milion border of the lip: it was ulcerated and raw, and secreted a 
watery, sticky fluid. While the entire mass was somewhat hard, 
the edge on the vermilion portion of the lip showed a very marked, 



CHANCRE OF THE LIP 61 

almost cartilaginous hardness. There was then poly-adenitis, and 
a maculo-papular eruption, which had been present for about 
one week. 

Under active mercurial inunctions, and mercurial ointment, 
diluted, as a local dressing, the disease did remarkably well, so that 
within two weeks the eruption had disappeared, and the lip was 
practically healed ; although mucous patches continued to de- 
velop in the mouth under treatment. Three weeks from the time 
he was first seen, it was recorded that there was only about one- 
half of the original induration left on the lip, the sore being en- 
tirely healed over : he then passed from observation for a while, 
but returned four months later, with mucous patches on the tongue. 

Xo definite facts were obtained in regard to the mode of infec- 
tion. He had lived a rough life in a mining district, had smoked 
various pipes lying around in an assayer's office, where he worked, 
and had kissed girls of doubtful character, before the sore appeared. 

Case XLIX. Chancre of upper lip. Mr. Y. W., aged 53, con- 
sulted me first March 29, 1890, on account of a small sore in the 
centre of the upper lip. He had noticed it not more than two or 
three weeks previous to his visit, beginning as a " sort of a pustule ; " 
he had not had any "cold sores." 

When first seen there was a button-like mass, about one-third 
of an inch in diameter, and raised perhaps a line above the sur- 
rounding tissue. It was covered in part by a crust, and part of it 
was raw and exuding: on pinching it gently a very well defined 
hardness was perceptible. He was placed at once upon mercury 
and chalk internally, in full doses, and the sore improved rapidly, 
so that in three weeks it had become covered with epidermis and 
ceased to secrete : but it retained its perfect character and appear- 
ance as a button for at least two months. He had very moderate 
secondary symptoms, but occasionally mucous patches would 
appear in the mouth, and later an onychia affecting almost all the 
nails. 

In searching for the source of infection, I found that he had 
repeatedly kissed a girl who had sore lips; the girl was brought to 
me and was found to have very active syphilis, alopecia, macular 
eruption, multiple adenopathy, and abundant mucous patches, in 
the mouth and throat. 

Although cautioned strenuously in regard to the danger of in- 
fecting others, this gentleman brought me his own son, sonic 



62 SYPHILIS INSONTIUM 

eight months later, with fresh syphilis, undoubtedly from infection 
through a chancre of the tonsil; this case will be mentioned 
later (Case LI.). 

Case L. Chancre of lower lip. Mrs. Y. X., a respectable 
looking woman of 59 years, applied for the treatment of an exten- 
sive tubercular syphilide involving much of the face ; three years 
previous she had had an eruption which had left scars on the arms. 
She gave a history of chancre of the lip, of which the scar could 
be seen in the centre of the left half of the lower lip. 

Case L. (bis) Chancre of lower lip. As these pages are pass- 
ing through the press, another case of lip chancre has come under 
my care. Mrs. J. H., aged 28, has a large protruding mass 
occupying the entire right half of the lower lip, an inch long by 
half an inch wide; the surface is smooth, deep red, and shiny; 
much adenopathy exists beneath the right jaw, and double post 
cervical adenopathy. 

The sore started from the burn of a cigar about six weeks ago, 
and probably became infected by kissing, or possibly from smok- 
ing cigarettes belonging to others. 

In addition to these fifty-one instances of chancre of the lip, 
there could well be counted four more personal cases in children ; 
these were presumably infected in the mouth, by mothers who had 
chancres of the breast, obtained by nursing strange children, and 
whose cases will be mentioned later. The exact site of the primary 
lesion in these children was not recorded, as the cases were observed 
some time ago, and before my attention was very specially directed 
to this subject. It is possible that the primary sores could not be 
recognized, for, as is well known, these are apt to be very indis- 
tinct, and of relatively brief duration, in the mouths of children 
who acquire them in nursing. 

CHANCRE OF THE TONSIL. 

Fifteen cases of chancre of the tonsil are here recorded, or, over 
thirteen per cent, of all the cases; seven of these occurred in 
females, and eight in males. In most of the instances the primary 
lesion was carefully observed, and demonstrated to others; in a 
few of the cases the history was so clear and conclusive that the 
diagnosis was accepted as certain. In nine cases the right tonsil 



CHANCRE OF THE TONSIL 63 

alone was infected, in three cases the left tonsil alone, and in three 
cases both tonsils received the infection. 1 

Case LI. Cha?icre of right tonsil. Master Y. Y. , aged 11 years, 
the son of Mr. Y. W. , Case XLIX. , with chancre of the lip, was 
brought to me by his father, November 9, 1890, on account of the 
condition of his mouth ; his father, a most intelligent gentleman, 
was acquainted with medicine, and, as he had been strenously 
cautioned in regard to the danger of infection, he had been on the 
lookout for any possible results in his family. It should also be 
stated that for particular reasons the servant girl, from whom the 
father had contracted his lip chancre, was still kept in the 
family, though under rigid care. 

It seems that while in the country, in July, there was noticed 
a swelling of the right tonsil, with some soreness, but no attention 
was paid to it, and in August there was an enlargement of the 
glands beneath the jaw on that side, followed, before long, by a 
swelling of the glands of the other side. By the first of Septem- 
ber the mouth began to be sore, and remained so until the date of 
his visit. No eruption had been noticed. 

When first seen the buccal cavity was full of mucous patches, 
and at the corners of the mouth they presented a peculiar pouting 
condition exteriorly ; the right tonsil was larger than the left, 
redder, and superficially ulcerated, and the left had abundant mu- 
cous patches. There was a very general adenopathy, submaxill- 
ary, post-cervical, cubital, and inguinal ; there was no lesion on the 
penis, nor any other sore on the body, so that we were forced to 
believe that the infection had entered the tonsil, which indeed, 
had presented all the accompanying phenomena. He had also a 
peculiar, earthy look, and malaise. The lesions melted away, 
under quarter-grain doses of calomel every few hours, and within 
ten weeks had entirely disappeared, but returned somewhat 
later. 

Case LII. Chancre of right tonsil. Miss Y. Z. , aged 19, a young 
woman of uncertain character, applied, on June 28, 1887, for 
the treatment of a general macular eruption, which was said to 
have lasted two weeks ; it was fading somewhat at the time of the 
first visit. There was tenderness over the tibiae and also painful 
periosteal swellings on the forehead. She utterly denied having 

1 See Clinical Notes on Chancre of the Tonsil, with analysis of fifteen cases. New York Medical 
Record, May 27, 1893. 



64 SYPHILIS INSONTIUM 

any sores on any part of the body, and also denied ever having 
had connection; her occupation was that of a singer in an operatic 
chorus, and when questioned alone she seemed alive to the im- 
portance of the case, and truthful in her answers, , 

The throat was complained of as being sore, and on examina- 
tion both tonsils were found to be large, very red, and eroded, 
and on palpation the right tonsil was found to present an almost 
cartilaginous hardness; the submaxillary glands were enlarged, 
those on the right side being the most affected. Under active 
specific treatment the eruption faded rapidly, and, by the end of 
three weeks, the throat was largely healed. She was lost sight of 
before the tonsillar induration had entirely disappeared. 

No direct cause for the infection was learned, but from the 
life she led, and the character of many with whom she was asso- 
ciated, it can readily be understood that such an accident could 
happen from drinking vessels, etc. 

Case LIII. Chancre of right tonsil. Mr. X. A., aged 19, ap- 
plied at myelinic at the New York Hospital, June 17, 1891, for the 
treatment of a severe acne, mainly on the back, which had lasted 
for many months. During my absence he was placed upon proper 
treatment, and the eruption improved. About August 1 he com- 
plained of a soreness of the throat, and went to a throat clinic, 
where the trouble was diagnosticated tonsillitis, and an iron and 
chlorate of potash mixture ordered. 

It was soon noticed that he had a general eruption, which was 
recognized as syphilitic, but no initial lesion had been discovered, 
until August 26, when I first saw the patient. 

There was then much general swelling of the right side of the 
neck, and the right tonsil was found to protrude fully one-half 
across the pharynx ; at the lower margin of it there was a raw 
surface about half an inch in diameter, sharply outlined, but irreg- 
ular in shape. On palpation this was hard, and the hardness in- 
creased later: the left tonsil was not enlarged, and never hard. 
The right sub-maxillary gland was enormously swollen, the left 
less so, and the post-auricular and occipital glands enlarged, those 
on the right side especially so. The genitals were healthy, no 
urethral or other chancre. The fellow confessed to bestial .prac- 
tices, up to July 4, about the time when he first noticed the right 
side of the throat sore. The syphilis ran a moderately severe 
course and he is still under treatment. 






CHANCRE OF THE TONSIL 65 

Case LIV. Cha?icre of left tonsil. Miss X. B. , a lovely young lady, 
of 21 years, came under treatment May 14, 1878; she had then a 
papular eruption upon both palms, the arms, thighs, legs, and 
body, with the history of its having made its first appearance 
about three months previously, after a period of malaise, with a 
sore throat and distressing neuralgia of the head. The young 
lady being an old personal friend of the family, the eruption was 
prescribed for, but no close investigation was made at the time 
as to the mode of infection; nor did I, at the moment, suspect 
that there had been an initial lesion on the tonsil, as I had not 
then had my attention particularly called to the frequency of the 
sore in this location. 

Upon close questioning later, however, it was learned that 
about Christmas time she began to experience the first symptoms 
of sickness, in the way of a soreness on the left side of the throat, 
a stinging pain, with a swelling beneath the jaw; this was soon 
followed by the early symptoms above mentioned. It was further 
learned that the young gentleman to whom she was engaged at 
the time, was of dissolute habits, and had recent syphilis; and, 
also, that at the date when the chancre of the tonsil was 
acquired by her, he had a very great amount of soreness of 
the tongue and lips, which, however, was then attributed to 
smoking. The engagement was broken off soon after she became 
infected. 

For various reasons the treatment for the disease was rather 
ineffectually carried out in this case, and at the expiration of even 
eight years from the date of infection, she still suffered greatly at 
times from nodes on the ribs, clavicle, radius and tibia, and occa- 
sionally had almost unbearable neuralgia. 

Case LV. Chancre of both tonsils. Mr. X. C, an effeminate- 
looking man, aged 22, much broken down in health, applied on 
June 22, 1887, for the treatment of syphilis. He denied all infec- 
tion by sexual intercourse, and there were no signs of a previous 
initial lesion on the penis, nor had he had any such. After some 
questioning alone, however, he gave the history of bestial prac- 
tices, charging his trouble mainly to a young man of wealth. 

In September, nine months before his visit, his throat be- 
came very sore, a couple of weeks after having been exposed, 
when both tonsils swelled and became covered with a white deposit, 
with enlargement of the glands in the throat. He then had fever 



66 SYPHILIS INSONTIUM 

and malaise, and was treated for diphtheria, until the occurrence 
of a general rash over the body, limbs and scalp, suggested the 
nature of the throat affection; a month later mucous patches ap- 
peared on the penis and scrotum, together with inguinal aden- 
opathy. He was then treated for syphilis and all trouble disap- 
peared except the sore throat. When seen, the tonsils were en- 
larged, but nothing characteristic remained. Subsequently he had 
some of the later manifestations of syphilis. 

Case LVI. Chancre of left tonsil. Mr. X. D., also aged 22, 
was another very similar case, seen some three years later, No- 
vember 15, 1890. He was a thin, rather effeminate young man, 
who also acknowledged evil practices. He came for the treatment 
of a very general maculo-papular eruption, many of the lesions 
being also pustular: there was general adenopathy, neuralgia, 
malaise, etc. 

On examination of the throat the left tonsil was found to be en- 
larged and very red, and about its centre there was a patch about 
half an inch in diameter, sharply defined, and distinctly ulcerated : 
on palpation the tonsil was of a very decided hardness; the 
glands beneath the jaw on that side were greatly enlarged. Ex- 
amination showed the penis to be free from any sores, or signs of 
them, nor was there any initial lesion elsewhere on the body than 
on the tonsil. 

Case LVII. Chancre of left tonsil. Mr. X. E., a printer, aged 
23, first noticed a pain on swallowing, four or five weeks before 
his first visit, June 4, 1887; two weeks later he discovered that 
the glands in the neck were swollen. 

When he came under observation the left tonsil was so large 
as to block up over one-half of the fauces: the surface was super- 
ficially ulcerated, of a livid color, and, at its upper portion espe- 
cially, very hard to the touch. The patient, who was a very intelli- 
gent man, had often palpated his throat and of his own accord 
spoke of the tonsil being ' ' as hard as a stone. " This hardness was 
repeatedly noted, and was even more marked at a little later period 
in the case. The cervical glands of the affected side were nearly 
all enlarged, and matted together with cellulitis ; there were a few 
mucous patches on the uvula and tongue, and some tenderness 
over the lower part of the crests of the tibiae. Two or three weeks 
after his first visit, a most perfect macular syphilide broke out over 
the entire body, quite overshadowing the abundant tinea versicolor 






CHANCRE OF THE TONSIL 67 

which he had had on the back and chest for twelve years. The geni- 
tals were intact. 

In regard to the mode of acquiring the disease in this case, 
no accurate knowledge could be obtained. He himself attributed 
it to drinking from the same cup with other workmen, he remem- 
bering having drank after one man with mouth-lesions ; he had, 
however, also had intimate relations with a number of women, 
but knew of none to whom he could charge it. 

Case LVIII. Chancre of right tonsil. Mrs. X. F., aged 27, 
whose husband was in the theatrical business, and had recent 
syphilis, came to my office April 7, 1891, on account of a pretty 
general, large, papular syphilide, which was freely distributed on 
the face, scalp, and neck, with some on the body and limbs. This 
had existed about seven weeks, and had been preceded by a great 
soreness of the right side of the throat, beginning six weeks pre- 
vious, or about three months before her visit. The eruption had 
begun upon the face. 

The right tonsil was found to be greatly swollen, extending 
high up behind the soft palate, and was all quite hard to the 
touch : on the lower portion there was an ulcerated and moderately 
excavated area : the left tonsil was about normal, with no hard- 
ness. She stated that a month or so previous the mouth was 
almost closed, and she could take only liquid food for several 
weeks. The glands beneath the right jaw were greatly enlarged, 
and there was some general adenopathy. 

The eruption yielded rapidly to specific treatment, but the tonsil 
was noted as still hard at the end of three weeks : a week or two 
later, under very active treatment the tonsil had diminished 
greatly in size, and the chancre had somewhat healed, leaving a 
whitish, depressed, star-shaped scar. No particular mode of in- 
fection could be discovered. 

Cask LIX. Cha?icre of both tonsils. Mr. X. G., aged 28, came 
under my observation, March 8, 1893, under rather curious circum- 
stances. 

His wife had been sent to me in consultation, a few days pre- 
vious, with a papulosquamous syphilide, very general on the face, 
trunk, limbs, and palms. Her physician was uncertain as to the 
diagnosis on account of the absence of reasons for the contagion, 
as her husband was a proper man, and there was no reason to 
suppose that he had contracted syphilis. I learned, however, that 



68 SYPHILIS INSONTIUM 

he had had a slight general eruption just before his wife, which had 
followed a severe and prolonged disease in the throat which had 
been called tonsillitis, and that he yet had a large swelling of the 
glands beneath the left jaw. I therefore asked to see him. 

On investigation it was learned that he had been very actively 
engaged in a political club, leading the singing, and smoking va- 
rious pipes, and drinking promiscuously after others, although 
never to intoxication. About the middle of October his throat 
had become very sore, with enlargement of the glands beneath the 
jaw on each side. He then had great malaise for several weeks, and 
a month or two later a general macular eruption appeared, of 
which there were traces still present ; the great adenopathy of the 
left side had developed a week or two before his visit. He had 
never had any active treatment, but a mixed anti-syphilitic course 
had been instituted a week or so previously, as he himself sus- 
pected that he had syphilis, although he had certainly not been ex- 
posed venereally since his marriage, five years previously. 

On examination the throat was red, and the left side particu- 
larly swollen; the right tonsil still showed a line of hardness, with 
the remains of an excavated ulcer ; no marked hardness could be 
made out on the left side. The glands under the left jaw were 
greatly enlarged and matted together. The genital region was 
absolutely free from past or present signs of primary lesion, and 
there was no other lesion than that in the throat. 

Case LX. Chancre of left tonsil. Miss X. H., a most estimable 
young lady, aged 32, of a good family, was sent to me, October 
19, 1876, on account of a general papular eruption, which covered 
the entire surface of the body, head, extremities and even the palms ; 
it was attended with much general aching pain, and with rapid 
loss of hair. The following history was then obtained : She had 
always enjoyed good health until on August 5, two months and a 
half before her visit, she noticed a soreness on the right side of 
the throat, followed shortly by swelling of the glands beneath the 
angle of the jaw of that side. Five weeks later the rash first 
began to appear and increased until the time of her visit. 

When first seen, the eruption was a most typical papulo- 
pustular syphilide, very extensively distributed and very abun- 
dant. On examining the throat, the right tonsil was seen to be 
the seat of an ulcer which had produced a considerable flat exca- 
vation, the tonsil was felt to be decidedly hard on palpation, and 






CHANCRE OF THE TONSIL 69 

the whole throat and pharynx was intensely red and congested ; 
beneath the angle of the jaw on the right side, there was an 
enlarged gland of the size of a hazel nut. 

The subsequent history of the case is most interesting and dis- 
tressing. After her first visit she returned to her home in a 
country town, and was under the care of her own physician, who 
was apprised of the nature of the disease and advised of the appro- 
priate treatment. One month later she returned with a severe 
iritis of the left eye, which, in spite of active treatment, left the 
eye much damaged by adhesions. Specific treatment was carried 
out more or less regularly for about two years, without active 
manifestations of syphilis, other than occasional mucous patches, 
when she was lost sight of for eighteen months. I w 7 as then 
telegraphed for, to see her in consultation, at her home in the 
country at some distance, and found her in a most deplorable 
state. She was in bed and perfectly helpless from the enormous 
amount of ulcerative lesions which covered a considerable portion 
of her face, arms, chest, and back, with some on the legs. The 
lesions were so acutely inflamed and so extensive that I suspected 
other causes than the syphilis, and soon discovered that there was 
a combined eruption from bromide and iodide of potassium ; and 
this eruption, which healed quite quickly on withdrawing the 
drugs and giving arsenic freely, left her so scarred, especially on 
the face, producing ectropion of both eyes, that her life is really 
blasted thereby. 

At this time, and subsequently, I learned that a year before I 
saw her last, she had had some strange nervous attacks of partial 
paralysis, having difficulty in talking and walking. I also learned 
that she had been subject, almost since childhood, to slight epilep- 
tiform seizures, which, however, were very infrequent and slight 
until the past two years, when, under the influence of the syphilitic 
poison, they had increased in frequency and severity. She then 
consulted some advertising epileptic doctor, and under the influ- 
ence of his medicines, the new eruption had first developed on 
the face, 'apparently as a bromide eruption, at first pustular and 
bullous. For this new manifestation of her syphilis, as it was 
supposed, iodide of potassium had been given in large doses by 
her physician, even until the day before I saw her. 

The history of the contagion in this case is also interesting. 
Some time after my first seeing this patient, the lady, Mrs. Z. P., 



70 SYPHILIS INSONTIUM 

whose case has been reported as No. XVI. , came under my care 
suffering from syphilis, acquired through a chancre of the lip; 
shortly after this date I had also under treatment, the husband of 
the last lady, who had been the means of giving the disease both 
to her and to the lady whose case is now under consideration ; he 
subsequently died of kidney-disease, as already mentioned , sup- 
posed to be due to his syphilis, which was well defined in him. 
On comparing the dates given it was found that he was first 
engaged to this lady, at a time when his mouth was full of mucous 
patches; when she acquired the chancre of the tonsil the cause 
was suspected and the engagement broken off ; he then at once 
paid attention to the second lady (Case XVI.), who received the 
chancre on the lip, and whom he afterwards married. 

Case LXI. Chancre of right tonsil. Mr. X. I., aged 32, had 
what was supposed to be tonsillitis of the right side, six weeks 
previous to his visit, February 13, 1889. The swelling of 
the tonsil had not gone down, and a few weeks afterward a gen- 
eral eruption had appeared, covering much of the body. 

When he first came for treatment the right tonsil was seen to 
be large, projecting half-way into the throat ; the surface of it pre- 
sented a superficial ulceration, the edges of which were quite prom- 
inent ; the glands on the right side of the neck were enlarged, with a 
smaller amount of adenopathy on the other side. There was a 
maculo-papular eruption on the forehead and body, which was fading. 

In order to observe the tonsillar lesion more carefully, he was 
left two weeks without specific treatment, and he was cautioned 
in regard to infection. On his second visit, one week after the 
first, it was noted that the margin of the ulcer was much more 
sharply defined, and that there was very decided hardness to the 
touch : he was given a strong chlorate of potassa gargle and the 
non-specific treatment continued. One week later he was placed on 
anti-syphilitic treatment, under which the tonsil gradually healed, 
and the swelling lessened. A ringed syphilide appeared around 
the mouth later, with abundant mucous patches. 

No clue to the infection could be discovered ; he drank beer 
rather freely, and thought that he might have smoked from 
another man's pipe. He had no lesions on the penis. 

Case LXII. Chancre of right tonsil. Mrs. X. J., aged 32, 
married ten years, the mother of four children, three of whom 
died of bronchitis or other non-specific diseases, entered the Skin 






CHANCRE OF THE TONSIL 7 1 

and Cancer Hospital, February 28, 1890, on account of a diffuse, 
large papular syphilide, tending to become pustular on the scalp. 

Her history is, that about two months previous she had a very 
severe sore throat, as her first symptom of ill-health, which con- 
tinued up to the time she entered the Hospital, accompanied with 
malaise and aching in the bones: a few weeks after the throat 
became sore she noticed "pimples" in the scalp, with very rapid 
falling of the hair : soon the eruption appeared on the face and 
spread over the body. 

On admission both tonsils were found to be greatly enlarged, 
almost meeting, and their surfaces seemed about equally raw, 
with mucous patches abundant upon the roof of the mouth, and 
elsewhere in the buccal cavity : there was much cervical adenop- 
athy, and a large, papular syphilide, most abundantly developed 
about the central region of the face, also scattered thickly through 
the scalp, and less abundant on the neck and body, with few 
lesions on the limbs. 

As the case was suspected to be one of tonsillar chancre, the 
genital region was carefully and deeply examined, without find- 
ing any trace of an initial lesion, although mucous patches were 
present, which had produced a soreness of the parts, a month or 
more after the first development of the trouble in the throat. 

Under free mercurial inunctions, and a bi-chloride of mercury 
gargle, the throat rapidly improved, the eruption faded, and the 
genital mucous patches healed, under applications of calomel, 
dusted on; but it was not until March 21, three weeks after 
admission, that the tonsils improved so much that a positive 
diagnosis of chancre could be made by observation. The left 
tonsil had then subsided considerably, but the right one still 
stood out prominently, presenting a rather sharply outlined ulcer, 
and a very marked hardness to the touch. 

No direct knowledge of the method of infection was obtained ; 
her husband, from her description, probably had syphilis, but was 
never seen. 

Case LXITI. Chancre of rigJit tonsil. Mrs. X. K., aged 33, a 
lady of refinement, came to my office, October 3, 1892, for the 
treatment of an eruption on the palms and soles which rendered 
movement difficult and painful ; there were many scattered pap- 
ules, some of them fissured, and there were discovered also 
remains of a papular eruption on the limbs. 



72 SYPHILIS INSONTIUM 

The diagnosis of syphilis was readily made, and it was learned 
that this had been preceded in July by an eruption thought to be 
measles ; there had been a previous period of malaise, and great 
falling of the hair since the eruption. 

On searching for the point of entry of the virus, it was learned 
that in June she had been taken with a stinging pain in the right 
tonsil, which shortly enlarged, and which she soon noticed to be 
very hard to the touch, and accompanied shortly with swelling of 
the sub-maxillary glands of that side. This was called tonsillitis 
by a physician in the country, but she had always questioned the 
diagnosis, as the swelling of the tonsil remained until the time of 
her visit, some months. While there had been no real ulceration, 
she described a superficially raw, well defined surface at the lower 
edge, which had healed before her first visit. 

When first seen the right tonsil was large and still hard, and 
the sub-maxillary and post-auricular glands on that side much 
swollen. No cause of infection could be learned, even after 
much questioning, and it was supposed that it occurred from a 
public drinking cup, as she travelled much in the cars, and drank 
often at the water cooler. 

Case LXIV. Chancre of right tonsil. Miss X. L., a most esti- 
mable young lady, aged 34, was sent to my office, May 24, 1889, 
on account of a very general, large, flat, papular syphilide, which 
was becoming scaly. 

At the time I did not attempt to make out any history of the 
infection, but gave treatment, and cautioned her in regard to the 
danger of communicating the disease to others. The eruption 
faded rapidly, and her health, which was much depressed by the 
disease, improved greatly. A little later I learned that she had 
just formed an attachment to a gentleman, some years older than 
herself, and she consulted me very seriously in regard to the pro- 
priety of marrying, for I found that she felt pretty certain as to 
the nature of her complaint. The case was then gone into very 
carefully, and I took every opportunity of discovering the mode 
of infection. She had certainly never had sexual intercourse, 
and examination showed that there was no reason to believe that 
a chancre had ever existed in the genital region ; there was, 
however, still a mucous patch or two, which had attracted her 
attention. 

It was then learned that about January 26, she had suddenly 



CHANCRE OF THE FINGER 73 

noticed a sore throat, soon after kissing, repeatedly, a cousin who 
had sore mouth and lips, which she then asserted were certainly 
from syphilis ; she had repeatedly assisted him in bathing out the 
mouth. The right tonsil soon became enlarged and remained so. 
The eruption began to develop on April i. 

Case LXV. Chancre of both tonsils. Mr. X. M., aged 46, came 
to me in consultation March 2, 1892, on account of an eruption 
which had appeared two weeks previous, first upon the forehead 
and scalp, and soon upon the body and limbs; the eruption was 
plainly a macular syphilide. 

He had not been exposed sexually for fully ten months, and 
he and his physician were at an utter loss to account for the 
possible infection ; the genital region was free from disease, and 
no trace of an extra-genital sore could be discovered on the ex- 
posed surfaces, or on the tongue or lips. The consultation being 
somewhat hurried he was given very active mercurial treatment 
without determining the site or mode of infection, and one week 
later there was a remarkable fading of the eruption, and he ex- 
pressed himself as feeling 50 per cent, better: the intense malaise 
and general rheumatic feelings had quite passed away. 

The case was now examined more carefully, and it was learned 
that two months previous to his visit he had noticed a stinging sen- 
sation, first in the right side of the throat, and thought that he 
was about to have another attack of "grippe": the throat had 
been quite sore, on both sides, ever since. On examination both 
tonsils were found to be enlarged and superficially ulcerated, the 
right one being most affected: both of them presented distinct 
hardness to the touch. The glands beneath the jaws on either side 
were enlarged, that on the right to the size of an almond : there 
was but moderate general adenopathy. 

It could never be determined how the infection took place. 

CHANCRE OF THE FINGER. 

Fifteen cases of chancre of the finger are found in the preced- 
ing list : of these ten were in physicians, who contracted syphilis 
in the discharge of their professional duties ; one was in a lady 
who acquired the disease while nursing a relative with an ulcerat- 
ing lesion; one was in a washerwoman, who was supposed to have 
become infected from washing the clothes of a syphilitic : and three 



74 SYPHILIS INSONTIUM 

were in men from unknown causes, although in one of these the 
infection on the finger appeared to be venereal in origin. 

In nine cases the lesion was on the right hand, and in six on 
the left ; the right and left index fingers were each affected in 
three instances, and the right middle finger in four instances. 

Case LXVI. Chancre of left index finger. Dr. X. N. , aged 29, a 
physician in active practice in a neighboring city, presented him- 
self, March 21, 1887, with the following history: Four or five 
weeks before his visit he noticed a swelling of the glands in the 
left axilla, which enlarged to the size of a pigeon's egg, remaining 
so for a couple of weeks, and improving rapidly under the local 
use of iodine ; he had noticed, for a little time before, a lesion on 
the back of the first joint of the left index-finger, which had not 
given him much trouble, and had quite healed at the time of his 
visit, without specific treatment. On January 26 he had delivered 
a syphilitic woman, who had had three abortions, and he remem- 
bers having had a crack in the skin in the location mentioned, the 
weather being very cold; the child died about two weeks after 
birth, with unmistakable syphilitic symptoms. He had attended 
many other confinements, but knew of no other syphilitic case. 

On the subsidence of the glandular swelling in the axilla, on 
March 1, an eruption developed on the breasts, back and thighs, 
accompanied by severe nocturnal headache. At the time of his 
visit, the eruption had become very copious and affected much 
of the body, with some spots on the face ; it consisted of large, 
flat, smooth papules, pretty evenly disseminated: he had also 
throat trouble. 

The site of the chancre of the finger presented a livid discolora- 
tion, with vestiges of a minute central slough, covered with an 
epidermic pellicle, and when carefully palpated, a distinct, parch- 
ment induration could be detected. The subsequent history 
presents some interest ; the eruption proved quite severe and 
relapses occurred, even under pretty active treatment: he after- 
wards suffered from heart trouble, said to be mitral stenosis, by 
an eminent auscultator, which greatly improved under more active 
anti-syphilitic treatment. His wife and one child, aged six years, 
have thus far escaped infection. As the chancre on the finger had 
not been recognized or treated, he must have exposed many 
others during the period before he came under observation, as he 
was in active general practice. 



CHANCRE OF THE FINGER 75 

Case LXVII. Chancre of left third finger. Dr. X. O., aged 31, 
first noticed a soreness about the base of the nail of the third 
finger of the left hand during the latter part of June ; this increased 
in severity, until a chancre of some size developed, which remained, 
though partially healed at the time of his visit, September 25, 
1884; it had been burned quite deeply with nitrate of silver, by a 
surgeon before he came under my direction. When first seen, 
the entire end of the finger was thickened and red, the nail was 
raised from its bed, and the almost healed ulcer presented a 
purplish, glazed appearance ; the finger was not painful ; he had 
had only local treatment, the application of nitrate of silver before 
referred to, poulticing, and a carbolic acid lotion, one to forty. 

Ten days before his visit a slight eruption had appeared upon 
the forehead, which increased until he presented himself. At this 
time a characteristic erythemato-papular syphilide covered much 
of the body ; there was also malaise with aching of the limbs, which 
he had considered malarial and treated with quinine ; the throat 
was congested and had felt sore for several days ; there was also 
pretty general adenopathy, cervical, cubital, and inguinal. He 
had not had much, if any, trouble from glandular swelling in the 
axilla, although his finger-sore had been of an ulcerating charac- 
ter almost from the first. This patient subsequently had quite 
severe iritis. 

The cause of the infection was not traced satisfactorily, although 
he charged it to a confinement case, which he had had about a 
month previous to the appearance of the sore, when a hydro- 
cephalic child was delivered, dead-born. 

The subsequent history of this case is most interesting, from the 
fact that the patient infected his wife, who was also under my treat- 
ment, and whose case deserves special mention; we were, however, 
never able to trace the mode in which the disease was conveyed to 
her. The case is as follows, given mainly in the words of the re- 
port of her husband, a very intelligent physician: 

Mrs. X. O., aged 30, was first seen March 17, 1885, almost six 
months after the first visit of her husband, the last-mentioned. 
case. She was always rather delicate, suffering from indigestion 
and constipation, and occasionally with delayed menstruation; she 
had had malarial symptoms from T878 to 1881. About December 
1, 1884, full two months after her husband's first visit, she began 
to feel poorly, with general malaise, pain in the back and limbs, 



76 SYPHILIS INSONTIUM 

loss of appetite, and some fever. These symptoms gradually in- 
creased until, on January i, 1885, she was compelled to take the 
bed. She was confined to bed for about three weeks, with what was 
diagnosed by several physicians to be a light attack of typhoid 
fever; she was constipated during this time. A slight eruption 
appeared on the abdomen and chest, which was noticed, and re- 
garded as an unusual form of typhoid exanthem. About February 
1, she began to complain of sore throat, which remained in spite 
of ordinary remedies : about March 1 the glands of the neck com- 
menced to enlarge. 

When first seen the patient had a slight, general, fading erup- 
tion, maculo-papular in character, over the upper limbs, and about 
the mouth and chin : on the palm of the left hand there remained 
one hard, darkish papule: the glands of the neck and elbow were 
enlarged, and the throat covered with mucous patches, and very 
sore. 

No clue could ever be found as to the method by which the 
poison was conveyed to her ; she had no initial lesion on any ex- 
ternal portion of the body, nor in the mouth ; nor could any trace 
of a primary lesion be found in the genital region or vagina, even 
by a well-known gynaecologist, who examined deeply for it. The 
case might possibly lend weight to the supposed communication of 
the disease by the seminal fluid; her husband, who had studied the 
case carefully, suggested, however, that infection might have 
occurred through a pregnancy, as he thought that she might have 
had a miscarriage very early in conception, but of this they could 
not be certain. 

Case LXVIII. Chancre of right middle finger. Dr. X. P., aged 
32, in active general practice, bruised the knuckle between the 
first and second phalanx of the right middle finger, on January 10, 
1889. The injury seemed to heal, but a crust formed, which came 
off several times, leaving a raw, unhealthy ulcer, which persisted 
until the time of his visit, March 14, 1889. A week after the in- 
jury he had a sharp attack of lymphangitis of that arm, and swell- 
ing and pain in the axilla: these passed off under local treatment, 
and the ulcer remained very quiescent thereafter, but refused to 
heal. 

When he came to my office there was an indolent ulcer occu- 
pying the width of the finger, and about half an inch in long di- 
ameter. The edges were quite sharply defined, but there was not 



CHANCRE OF THE FINGER 77 

the slightest suggestion of hardness ; the sore was but little ele- 
vated, and had a grey, pultaceous base; there was no cubital 
adenopathy, but some axillary swelling remained. He was some- 
what run down, but presented no marked malaise, there was no 
eruption, no mucous patches, no adenopathy, nor anything to in- 
dicate constitutional infection. 

From the situation it was thought that the ulcer might have 
been kept open only by the movements of the finger ; accordingly, 
the sore was protected by cotton, the finger splinted, and the diag- 
nosis given that the sore was probably not the initial lesion of 
syphilis. 

From letters received later, however, it was learned that very 
shortly after his visit full constitutional symptoms appeared, and 
the sore yielded rapidly to specific treatment ; he has, moreover, 
suffered most severely from later manifestations, which have 
greatly undermined his health. 

No possible cause for the infection was discovered. 

Case LXIX. Chancre of left middle finger. Dr. X. Q., aged 37, 
first noticed a sore point on the end of the middle finger of the left 
hand, in July or August, 1884, and some remains of the sore were 
still visible when seen, sixteen months later, December 12, 1885. 
The lesion had been hard and wart-like, and had nev r er ulcerated 
much; it had been burned several times with Paquelin's Cautery, 
and he had taken mercury off and on to meet syphilitic symptoms, 
which appeared four months after the sore developed on the finger. 
When seen, there were the remains of a tubercular syphilide on 
the forehead; the eruption, and also the remains of the finger 
chancre yielded rapidly to mixed treatment aided by mercurial 
plaster to the finger. 

No special mode of infection could be made out; he was en- 
gaged in general practice and obstetrics. 

Case LXX. Cha?icre of right index finger. Dr. X. R., aged 37, 
scratched the back of the last phalanx of the right forefinger, in 
an operation on a patient with active syphilis, and for two months 
the spot remained sore but did not present any clear signs indica- 
tive of a chancre; there were few, if any, glandular enlargements 
of that arm. While the finger was sore he had headache and 
malaise, which were relieved by mercury, and about two months 
later he had a macular eruption with sore throat and tongue. He 
took mercurials irregularly, always with great relief to all symp- 



78 SYPHILIS INSONTIUM 

toms, and had continued to take the same off and on up to the 
time of his visit, November 22, 1890; he stated that he missed 
them when long omitted. 

From the time of his infection he had had more or less symp- 
toms of syphilis for four years, and when seen there were very 
characteristic groups of tubercular eruption over the left eyebrow, 
on the left fore arm and on the prepuce, all of which yielded 
rapidly to mixed treatment ; there was also periosteal tenderness 
of the right tibia. 

Case LXXI. Chancre of left third fifiger. Dr. X. S., aged 40, 
performed an operation for phymosis, and also one for dead bone, 
on August 4, 1 881; the latter patient had constitutional syphilis, 
there is no record in regard to the former. A few days after the 
operation he experienced septic symptoms, followed by abscesses 
in the axilla and elbow, some of which aborted and others were 
opened, about ten days after the operation. Three weeks after 
the operation, or five weeks before his first visit, September 30, 
1 88 1, he first noticed a sore on the end of the index finger of the 
left hand, on the ulnar side ; at first it was flat and secreted a 
serous fluid. On the radial side of the ring finger he noticed 
another sore, on a level with the skin, which healed over, but had 
again opened, and bled easily at the time of the visit. There had 
been only local treatment, with cauterization and iodoform. 

When first seen there were sores on the two fingers mentioned, 
the index and third fingers of the left hand. That on the end of 
the index finger, near the free extremity of the nail, presented a 
fungus-like appearance, suggestive of dead bone beneath ; the 
mass was of oval shape, one-third by one-half inch in diameter, of 
a livid red color, and slightly ulcerating ; it was not painful, and 
no induration could be perceived. 

The sore on the third finger presented quite a different appear- 
ance; it was on the radial aspect, near the root of the nail, half 
an inch in diameter, circular, almost on a level with the skin, 
-raw, and bleeding easily. There was no eruption on the body, 
and little, if any, glandular enlargement could be detected. He 
was placed upon mixed treatment, and in ten days the sores 
showed a most remarkable improvement ; the fungus-like charac- 
ter of the ulcer on the index finger had almost disappeared, and 
that on the ring finger had nearly healed over, leaving a glazed 
surface. Some swelling ' of the glands was noted. Two weeks 






CHANCRE OF THE FINGER 79 

later a fine, maculo-papular eruption appeared, which increased 
till it became very general, and mucous patches appeared, which 
were afterwards, at times, troublesome. 

Case LXXIL Chancre of right thumb. Dr. X. T. , aged 40, 
acquired a chancre beneath the nail of the right thumb, with 
enlargement of the cubital and axillary glands. Secondary symp- 
toms followed at once, upon the skin and mucous membranes, 
and remained off and on until seen July 19, 1885, a year and a 
half after the chancre. 

At this time the head, arms, and nearly the entire surface of 
the body was the seat of a late papular syphilide, rather promi- 
nent, with mucous patches in the mouth. On the left index 
finger, on its dorsal aspect, just below the root of the nail, there 
was a sore which was very suggestive of a chancre, but which 
proved to be but an ulcerated papule or group of papules, possi- 
bly the seat of further septic infection ; it had existed three weeks, 
and when first seen extended across the width of the finger, and 
was perhaps one-third of an inch wide ; the mass seemed infiltrated 
and was raw and sloughy, with no excavation nor raised edges. 
The general eruption yielded promptly to mixed treatment, but 
the sore on the finger resisted, showing, as remarked, signs of 
probable further septic infection, possibly with chancroidal 
virus. 

Case LXXIII. Chancre of right middle fi?iger. Dr. X. U., aged 
42, consulted me on April 28, 1890, on account of a very gen- 
eral, maculo-papular eruption, tenderness over the sternum, and 
general adenopathy, which had existed for five or six weeks. 
Recognizing the syphilitic nature of the eruption he was closely 
questioned in regard to infection, of which he was entirely uncon- 
scious ; he had certainly had no venereal exposure. 

After some search there was found on the radial side of the 
right middle finger, by the side of the nail, a hard, red, shiny 
patch, which had been more or less sore, but which had not given 
much annoyance, and had not been specially treated, except by 
protective coverings. It was then found that there had been 
axillary adenopathy on that side, and since that had appeared he 
had felt weak and run down, but had not suspected the real nature 
of his complaint ; he had paid little attention to his trouble until 
the eruption had extended to the face and hands, and caused him to 
seek relief; he must, therefore, have exposed many in his practice. 



8o SYPHILIS INSONTIUM 

The infection was traced directly to a lady of wealth and posi- 
tion, whom he had confined January 24, of a baby which died 
syphilitic on April 9. The lady was seen by me in consultation, 
May 14, with a profuse general eruption, affecting also the palms, 
very great alopecia, and other signs of very active syphilis. 

Case LXXIV. Chancre of right i?idex finger. Dr. X. V. , aged 

43, first noticed a small papule, which he thought to be an insect 
bite, on the inner side of the right index finger, opposite the first 
phalangeal joint, about the first of August, three or four weeks 
before his first visit, on August 25, 1889; this spot inflamed, and 
ten days later it broke, as a pustule, leaving a raw surface, which 
had remained sore to the date of observation. 

When first seen there was a round, sharply defined, slightly 
elevated, red patch, with a thin, epidermal covering, presenting 
some hardness on palpation : there was no adenopathy of that arm. 
He had seen several physicians who were doubtful as to the diag- 
nosis, and advised abstaining from specific treatment until the ap- 
pearance of constitutional symptoms; this advice was followed, 
although the sore was dusted with calomel. 

He was next seen nearly eight months later, when it was 
learned that the sore had become more indurated, and had per- 
sisted two months or more, resembling a Hunterian chancre; he 
had had recurrent iritis, and, when seen, had the mouth very sore 
from mucous patches, which had existed three weeks. 

The source of infection could not be traced ; he had, however, 
had several confinement cases just before the first appearance of 
the sore upon the finger, and the husband of one of the women 
had symptoms suggestive of syphilis. 

Case LXXV. Chancre of right index finger. Dr. X. W. , aged 

44, noticed a small pimple on the radial side of the root of the right 
index finger, at its junction with the hand, four weeks before his 
visit, May 27, 1893. This crusted over and refused to heal, increas- 
ing in size, and on May 20, one week before his visit, he noticed a 
macular eruption on the arms : this increased rapidly, so that when 
seen the body, legs, and arms were thickly covered, and there was 
one small papule in the right palm. There had been no sore 
throat, no general pains, and no general adenopathy. 

The initial lesion was not over half an inch in diameter, red, 
indolent, with a small scabbed point in the centre : it presented a 
distinct hardness on palpation. The diagnosis was confirmed by 



CHANCRE OF THE FINGER 81 

several other medical men acquainted with the subject in this 
city. 

No particular source of infection was learned, but as he was 
much in obstetric practice, and this portion of the hand would be 
apt to rest against the soft parts, in digital examination, it was 
undoubtedly from this source. 

We have now two cases of chancre of the finger in females, one 
of whom appeared to have acquired the primary sore in caring for 
a relative with a syphilitic eruption, the other in washing the 
clothes of a young man who had syphilis. 

Case LXXVI. Chancre of right third finger. Mrs. X. X., an 
intelligent lady, aged 64, came under treatment September 16, 
1887, on account of a tubercular syphilide of the centre of the face 
and right lip, of five years duration : the eruption had aways been 
considered as lupus, and she had been under the care of several 
physicians in a neighboring city, and had been treated mainly by 
cauterization and by arsenic. The lesions were very characteristic 
of syphilis, and the eruption yielded to specific treatment with re- 
markable rapidity. 

Upon very careful investigation into the history of the case it 
was discovered that twenty } T ears before she had had a sore on the 
third finger of the right hand, which gave a perfect history of 
chancre ; its healing was followed by constitutional symptoms, 
debility, bone aching, general eruption, etc. She had been taking 
all the care of a relative, who had an ulcerative disease about the 
eye, changing the dressings, etc. , for six or seven months, during 
which period the finger became sore at the root of the nail, whereby 
the latter was lost; the site of the former sore was marked by a 
depressed cicatrix, with no attempt at nail formation. 

Cask LXXVII. Chancre of left index finger. Mrs. X. Y. , aged 
38, was engaged in washing the clothes of a young man, said to 
have syphilis, in November, 1890, four months previous to her 
visit, March 27, 1891. Without any appreciable cause, the left 
index finger, on the radial side of the edge of the nail, began to be 
affected soon after she began the washing, and continued to be sore 
for fully two months; the surface became raw and painful, with 
exuberant granulations, into which a doctor cut down, without 
getting anything but blood. At this time she had swelling of the 
glands at the elbow and axilla, and much general malaise. The 

7 



82 SYPHILIS INSONTIUM 

first eruption she had noticed on the body was that for the relief of 
which she came, which had appeared about a month or so previous 
to her visit. 

When first seen the finger had about healed, leaving a red, 
depressed scar, a third of an inch or so in diameter, near the root 
of the nail. On the body and limbs were the remains of a pustular 
eruption, unmistakably syphilitic, and brown stains left by pre- 
ceding lesions. 

The next three patients, males, presented most marked and 
perfect chancres of the finger, one of which, at least, was probably 
of venereal origin ; the cases were seen very early in their course, 
and water- color drawings made, and they were watched for a con- 
siderable period thereafter. 

Case LXXVIII. Chancre of right middle finger. Mr. X. Z. , aged 
24, gives very little history in regard to the first development 
of the sore on the finger, which had existed some weeks when 
he first presented himself for treatment, October 4, 1889 ; it 
had begun, apparently, as a hang-nail, on the ulnar-side of the 
middle finger of the right hand, and had become more and more 
inflamed until the time of his visit. ' 

When first seen, the end of the finger was greatly inflamed 
and very sore, with an ulcerating surface around the entire base 
and sides of the nail, which was itself discolored and loosened; 
on the ulnar side there was an extension of the ulceration to the 
side of the finger. The cubital glands were not enlarged, but 
those in the right axilla were much swollen. There was just 
developing a large papular syphilide, which was remarked to be 
much more abundant on the right hand and arm than elsewhere ; 
he subsequently had mucous patches and other signs of constitu- 
tional syphilis. 

Nothing definite was discovered as to the source of infection; 
he was employed in a large dry goods house, where he used the 
same towel with many others, but he did not deny, also, mingling 
with women of loose character, and it was thought that the finger 
was possibly inoculated during sexual intercourse. 

Case LXXIX. Chancre of left i?idex finger. Mr. W. A., aged 25, 
came to the New York Hospital for the treatment of gonorrhoea, 
August 19, 1 89 1, and in my absence was placed under treatment 
by my assistant. 






CHANCRE OF THE FINGER 83 

The following week, while examining th ;ate of the discharge, 
I observed some flat papular lesions on the git hs penis, which led 
me to examine further ; the entire. body and In e then found 

to be the seat of a maculo-papular syphilide. \;.-:j.ihadbecome 
scaly in some places on the legs, and pustular ir alp, with 

very general adenopathy. The man had nor >f the 

eruption until his aticiiuon was directed to it. 

Search was made for the primary lesion, but the geiiita ^gion 
was found to be free from such, nor was there any evidence of a 
chancre about the mouth or throat. It was then noticed thar the 
left index finger was bound up, the man explaining that he had 
injured it, and it was being treated with salve by a druggist. 

On examination an ulcerating surface was seen involving all 
the tip of the finger, and extending beneath the nail, which was 
long and protruding: the surface was raw, moist, and shiny, but 
no hardness could be made out. There was very great adeno-pathy 
at the left elbow and some in the axilla, none in corresponding- 
locations on the right side. 

There was no explanation found for the infection ; he had been 
fishing six weeks previously, and it was sore since that date. The 
ulcer yielded promptly to vigorous mercurial treatment. 

Case LXXX. Chancre right ?niddle finger. Mr. W. B., aged 
26, injured the skin at the root of the nail of the right middle 
finger, seven weeks before his visit, by bruising it against a box. 
The abrasion failed to heal, and soon began to ulcerate, and con- 
tinued sore until his visit ; he had kept it poulticed much of the 
time. 

When first seen, November 21, 1883, the end of the finger was 
greatly swollen, and the root of the nail was involved in a large 
ulcer extending well on to the base, rather more on the ulnar side, 
covering an area of over half a square inch ; the tissues were soft 
and movable, and no induration could be made out. There was a 
large, painless gland, just below the right axilla, the size of an 
almond, and a smaller swelling in the left axilla; inguinal aden- 
opathy also existed. The entire body was covered with a maculo- 
papular eruption, developed in some places into large, flat papules ; 
the palms also were thickly covered. There had been no rheu- 
matic pains or sore throat. The chancre on the finger proved 
very rebellious to treatment, and gave a great deal of pain in its 
further course ; it did not heal for nearly three months, although 



84 SYPHILIS INSONTIUM 

he was faithful in attendance, and active anti- syphilitic measures 
were employed, in addition to local treatment. The constitutional 
symptoms were pretty severe and prolonged, but finally all ceased, 
and when seen lately, over seven years after infection, he was in 
perfect health ; he had had no treatment for several years. 

CHANCRE OF THE BREAST. 

Seven cases of chancre of the breast are here recorded: five of 
these occurred in nursing mothers, three of whom infected their 
own nursing children: one case occurred in a very excellent 
woman, in private practice, who was not nursing, and who prob- 
ably acquired the chancre from her husband's mouth ; they resided 
in a distant city, and he was never seen : the other case was in a 
young woman, on the skin of the breast, away from the nipple, 
probably from kissing. 

Case LXXXI. Chancre of the breast. Mrs. W. C, aged 26, pre- 
sented herself, December 18, 1876, at the Demilt Dispensary, with 
well-marked chancre of the breast, which was acquired two or 
three months previous to her visit, by nursing a strange child who 
had sores about the mouth. Her' own child, eight months old, 
was also brought at the same time to the clinic, with an abundant 
macular eruption, similar to that seen in acquired syphilis in older 
persons. The records are imperfect in regard to this case, and no 
statement is made as to where her child received the infection, it 
being only recorded that the child was born healthy, and that the 
eruption was of very recent development. 

Case LXXXII. Chancre of the nipple. Mrs. W. D., aged 27, 
had been bringing her child to the Dispensary at intervals for over 
a year, for impetiginous eczema, from the time when he was seven 
months old; she then presented herself, on February 11, 1877, 
with a well-marked chancre of the nipple. She remained under 
observation but a short time after this, and notes of the case have 
not been preserved. 

Case LXXXIII. Chancre of left nipple. Mrs. W. E., aged 29, 
a married lady, who had never had any children, was sent to my 
office on December 6, 1880, on account of a very general eruption 
of a large, scaly, papular syphiloderm, which was especially 
profuse and distressing on the face. The eruption had existed 
fully three months, and had been preceded by great malaise 






CHANCRE OF THE BREAST 85 

and a very bad sore throat, she stating that she came very near 
having diphtheria. 

In seeking to establish the mode of entrance of the poison, it 
was learned that she had first experienced a soreness of the left 
breast about five months previously, and shortly after this a lump 
was noticed under the left arm ; this had been treated by poultices 
and the eruption soon followed. The breast lesion was very small 
at first, and discharged a little, but it gradually increased until it 
was an inch in diameter and involved all the nipple, the entire 
breast also becoming much swollen : the axillary adenopathy sub- 
sided without suppurating. She had had some specific treatment, 
as the nature of the disease had been suspected by her 
physicians. 

When first seen there was an ulcer, about three-quarters of an 
inch in width, occupying the site of the left nipple, with sharply- 
defined edges, and a red, raw-meat looking surface, giving off a 
sticky secretion. Under active treatment much of the eruption, 
which was rather a peculiar one, with thick, succulent lesions, 
disappeared within a few weeks; the chancre also began to im- 
prove rapidly, and by December 28 was almost entirely healed, 
when she left for her home in another State : at that time some 
distinct hardness could be felt in the chancre, but previously this 
was hardly recognizable. She was seen on later occasions and 
exhibited palmar and plantar syphilides, throat lesions, etc. 

It was never discovered exactly how the breast became infected, 
but it was supposed to be from her husband: he was never seen, 
as he was much occupied with his business in a distant city. 

Case LXXXIV. Chancre of the nipple. Mrs. W. F., aged 30, 
presented herself for the treatment of cutaneous gummata on 
various portions of the body. Some time previously she had taken 
a strange child to nurse, from an asylum : three or four weeks 
later an indurated sore had developed on the nipple, which was 
followed shortly by symptoms of constitutional syphilis, which 
were more or less continuous until she applied for treatment. 

Case LXXXV. Chancre of left nipple. Mrs. W. G., aged 32, a 
very intelligent patient, was obliged by the sudden death of her 
husband to take a strange child to nurse, when her own was but 
a few months old. Fearing contamination she very carefully kept 
the strange child on the left breast, while she sedulously gave the 
other alone to her own child. Within some weeks the foundling 



86 SYPHILIS INSONTIUM 

died, with fully developed hereditary syphilis, and the mother then 
gave both breasts to her own child. 

A short time afterward, the breast which had nourished the 
strange child became sore on the nipple, and the nicer resisted 
treatment for a long time, so that after a while her own child 
ceased to nurse -from it, and was kept on the other breast alone. 
Some weeks later she became affected with general symptoms, 
and when she applied for treatment, September 12, 1878, she had 
a well-marked papulo- tubercular syphilide. 

Her child also developed the disease before long, and had vari- 
ous lesions on the skin, and subsequently suffered much from 
bone-syphilis, which produced considerable deformity in the tibiae 
and ulnae. 

The child has been seen repeatedly, at various times, up to 
the age of thirteen years, though quite irregularly, and the mother 
has from time to time come for treatment of late gummy lesions. 

Case LXXXVI. Chancre of the nipple. Mrs. W. H., aged 35, 
had noticed a sore on the nipple for some time previous to her 
first visit, October 13,. 1876, but could give no definite history as 
to its origin. It was recorded as a typical hard chancre of the 
nipple, but the notes of the case are scanty. Her child, a girl 
aged thirteen months, was brought with syphilis, with the history 
that it was born healthy and had acquired the disease since its 
mother became affected, but no- further record was made as 
to the existence of any buccal chancre on the child ; we know, 
however, that in nursing children these are often very slight, and 
frequently escape recognition. 

Case LXXXVI I. Chancre on side of breast. Mrs. W. I., an 
actress, aged 22, came to the New York Hospital, for treatment, 
August 24, 1892. 

On the skin of the left breast, fully an inch from the areola, 
there was a sharply cut, round ulcer, about three-quarters of an 
inch in diameter, with a reddish base, giving off a small amount of 
glairy secretion. When first seen it did not seem hard, but a week 
later this feature was well marked. 

She had a pretty general, diffused, small scaly syphilide, with 
mucous patches about the vulva and anus; mucous patches also 
in the throat. She attributed the ulcer on the breast to kissing. 

Case LXXXVI I. {bis). Yet another case of chancre of the 
breast should be added to this list. Mrs. O. O., aged about 19 



CHANCRE OF THE TONGUE 87 

years, seen once in consultation, had a chancre of the left breast, 
just above and to the left of the nipple. The sore had lasted a 
couple of weeks, presented some hardness, had a red, eroded sur- 
face giving off a glairy secretion, and already there was some 
axillary adenopathy of that side. No notes of the case were taken, 
and nothing could be learned of the source of contagion. 

CHANCRE OF THE TONGUE. 

Six cases of chancre of the tongue were met with, all of con- 
siderable interest. There were three in males and three in 
females ; in three instances the sore was on the left side of the 
tongue, in one on the right side, in one the side was not recorded, 
and in one it was on the back of the tongue. 

Case LXXXVIII. Chancre of back of tongue. Miss W. J., aged 
22, an estimable young lady, was referred to me, July 14, 1893, 
on account of an unusual papulo-pustular eruption, confined almost 
wholly to the arms and legs, with a very few lesions on the face. 
From its many peculiarities, and the absence of concomitant 
symptoms, it was not regarded as syphilitic, but as a peculiar 
folliculitis, possibly caused or increased by the iodide of potas- 
sium which she had been taking from a former physician on the 
belief that it was syphilitic. She was put upon pretty active non- 
specific treatment for four weeks, without producing much im- 
provement in the eruption ; she was then given mercury and 
chalk, every two hours, with the effect of almost instant improve- 
ment, and in two weeks the lesions had largely disappeared leav- 
ing only brownish stains. 

On close investigation it was found that in February, six months 
before her visit, she experienced pain on swallowing, which 
increased greatly, confining her to the house for three weeks ; she 
then was treated by a competent laryngologist, who said that 
there was a curious ulcerated patch on the root of the tongue, just to 
the right of the median line, different from anything he had before 
seen in that location. This sore lasted for a month more, finally 
yielding to active local medication, and some mild mercurial 
treatment, with iodide of potassium ; the glands on both sides of 
the neck were swollen, and remained enlarged at the time of her 
visit to me, and thereafter. A month after beginning the 
throat treatment, and seven weeks after first noticing the sore, the 



SS SYPHILIS INSONTIUM 

papulo- pustular eruption appeared; there had been great malaise 
which was supposed to be from the diphtheria, which her trouble 
was thought to be. 

No clue could be obtained as to the probable source of infec- 
tion ; she was engaged to be married, but for certain reasons her 
fiance could not be interviewed. 

Case LXXXIX. Chancre left tip of tongue. Miss W. K. , an 
intelligent and modest girl, aged 25, a sales-lady in a dry-goods 
store, applied at the New York Hospital, on October 31, 1888, 
for the treatment of a sore tongue, which she naturally feared to 
be cancer. 

The history was, that about six weeks previously she had first 
noticed a small ulceration on the left side of the tongue, followed 
a few weeks later by swelling of the glands beneath the jaw on 
that side. The soreness increased continually up to the time of 
her visit, when it gave her very considerable pain in eating and 
drinking, and even in talking there was much discomfort. 

When first seen, there was a small induration on the left side 
of the tip of the tongue, with a fissure through its centre. Two 
weeks later, when a water-color drawing was made, the lump had 
increased materially in size, the entire left half of the tongue was 
much reddened, and a star-shaped fissure was seen, nearly half an 
inch across, of a deep red, with whitish edges; the mass in the 
tongue was of a very decided hardness and the size of a hazel-nut. 
The under surface of the tongue, on the left side, was covered with 
mucous patches, which also existed in the throat and on the lips. 
The sub-maxillary glands on that side were greatly enlarged, but 
there was no general adenopathy, and as yet, no eruption. Later 
the post-auricular and other glands enlarged, and a ringed maculo- 
papular eruption appeared around the mouth. Under active treat- 
ment the sore began to improve, and the mucous patches disap- 
peared, but it was not until about two months that the ulcer had 
healed, and the hardness remained for some considerable time 
longer. 

After repeated questioning of her alone, I could not discover 
that she had been in any way exposed to syphilis ; she lived quietly 
at home, and had no intimate male acquaintances. I was led, 
therefore, to accept the probability that the poison was conveyed 
by the means of pins, which injured and inoculated the tongue, as 
she was in the habit of placing them in that side of the mouth 



CHANCRE OF THE TONGUE 89 

regardless of where she had obtained them; she herself remarked 
that she must have been poisoned in this manner, as she was con- 
scious of having thus wounded the tongue. 

Case XC. Chancre left tip of to?igne. Miss W. L., an in- 
telligent girl, aged 26, of good appearance, applied on December 
20, 1878, for the treatment of a ringed papulo-erythematous syph- 
ilide about the mouth, with a few patches of slightly scaly syph- 
ilitic eruption elsewhere, which had existed for two weeks: she 
complained of the throat, and on examination mucous patches were 
found on the palate and tonsils. 

On the left side of the tip of the tongue was found an ulcerating 
sore, which, on questioning, was found to have existed some little 
time, and to have been the first lesion to attract attention. This 
ulcer was somewhere about half an inch in diameter, a little 
raised, sharply defined and very hard: the anterior cervical glands 
were much enlarged. She denied utterly having ever had sexual 
intercourse, and the contagion was traced, in all probability, to a 
female friend with syphilis also attending the clinic, with whom 
she had had much to do, using the same utensils, etc. 

Case XCI. Chanc7-e of left side of to?igne. Mr. W. M., a 
married gentleman, aged 41, was brought to me in consultation 
October 6, 1888, on account of a sore tongue, which had refused 
to heal under ordinary local measures. 

On examination, there was a small, round mass, hardly one- 
half of an inch in diameter, on the left side of the tongue, near the 
tip, which was sharply defined, decidedly red, shiny, and presented 
a marked, though not very great, hardness; the glands under the 
left side of the jaw were swollen. There was no other sore any- 
where, neither on the penis, nor on any other portion of the body. 
The patient and his physician thought that he had no eruption, 
but, on stripping, the body was almost entirely covered with a 
distinct macular syphilide, which must have been of very recent 
appearance. I learned from his physician that he subsequently 
had many other manifestations of the syphilitic poison, and had 
not quite recovered when he passed from his care. 

The exact source of the inoculation could not be learned. He 
had broken a bit from the front lower tooth five weeks previously, 
and the sharp edge had irritated his tongue : he then went to a 
strange dentist, of not very good practice, and had the tooth filled, 
and soon after that the sore had developed more prominently. 



9© SYPHILIS INSONTIUM 

But he was also a great smoker, and he had likewise drank, more 
or less, in tasting beer in his brewery, from the same jug which 
his brewer had tasted, the latter having had syphilis, with sore 
throat, not very long before. 

Case XCII. Chancre of side of tongue. Mr. W. N. , a bricklayer, 
aged 43, presented himself February 7, 1885, with a macular syph- 
ilide and mucous patches. At the first visit, no trace of the mode 
of entrance of the poison was found, possibly from the haste of the 
examination, but it is recorded that the penis was normal. 

One week later, on careful examination, a healing chancre was 
found on the side of the tongue, with a very distinct hardness at 
its base. No clue was obtained as to the mode of infection ; the 
patient had been drinking heavily some time before its occurrence. 

Case XCIII. Chancre right side ofto?igue. Mr. W. O., a gentleman 
of intelligence and position, aged 60 years, came to me September 
11, 1884, on account of a sore on the tongue, which he feared to be 
a cancer. The history was, that he had first noticed a little point 
of soreness ten weeks before his visit, which had gradually increased 
in size, in spite of treatment at the hands of another physician, 
who apparently had not recognized its character, until, latterly, it 
had come to give him considerable annoyance, so that he was con- 
scious of its presence at all times. 

On examination there was found on the right side of the tongue, 
about an inch from its tip, a hard, inflamed mass, nearly half an 
inch in diameter, the centre ulcerating, and the edges somewhat 
everted, and presenting a little hardness when pinched ; it was not 
painful except when irritating food or drink touched it. The two 
upper molars on that side were found to have sharp and rough 
edges, and he had been wearing a red rubber plate until recently. 
There was a small, enlarged and painful gland beneath the jaw on 
that side. 

Thinking that the lesion might possibly be due to irritating 
local causes, he was given a soothing mouth-wash and an alkali 
internally. Five days later there was a marked improvement in 
the sore, he had had the roughened teeth smoothed off by his 
dentist, and had left out his set of artificial teeth. The ulcer then 
had a less angry look, but its edge presented a hardness sugges- 
tive of parchment, was more clearly defined, and the surface less 
ulcerated; the glands beneath the jaw were more swollen and 
hard. 



CHANCRE OF THE CHEEK 91 

The diagnosis of chancre of the tongue was then recorded, and 
the patient placed upon active an ti- syphilitic treatment. Three 
days later it was noted that the ulcer on the tongue had improved, 
had diminished in size, and that the glands beneath the jaw were 
smaller and more distinct. He then called my attention to cer- 
tain large, flat, red points on the palms, and these were found to be 
part of a general, maculo-papular eruption which had just appeared, 
and which covered much of the body ; it was learned that he had 
had considerable malaise during the preceding month. The 
chancre healed rapidly and steadily under the specific treatment, 
with no local measures, and six weeks later it was recorded that 
there was only a scar, with very slight hardness at its base, and 
no swelling beneath the jaw. 

In searching for the mode by which the syphilitic poison gained 
entrance, it was learned that during the month or so previous to 
the appearance of the sore, he had been, through the persuasion 
of a friend, under the care of a dentist of the cheaper, advertis- 
ing order, who, he had noticed, was not at all cleanly in his person 
or instruments. He could not locate the date of injury of the 
tongue by the dental instruments, but work was done in that 
locality, and he remembered the instrument occasionally slipping, 
but did not recall having had the tongue injured. He was a 
married man, with a family, and had certainly not been exposed in 
sexual intercourse, nor in any other manner of which he was con- 
scious ; he was very intelligent and greatly interested in learning 
how he had acquired the disease. The probability is therefore 
very strong that the poison was conveyed on the dental instru- 
ment from some preceding patient who had active syphilitic lesions 
in the mouth. 1 

CHANCRE OF THE CHEEK. 

Five cases of chancre in this locality, two of which are of very 
great interest, are recorded here ; all of the cases were in males, 
and in all but one of the cases the virus probably found entranc • 
through razor wounds, as also in the cases on the chin. In three 
instances the sore was on the left cheek and in two on the right. 

Case XCIV. Chancre of left cheek. Mr. W. P., aged 22, a 
plumber, applied at the New York Skin and Cancer Hospital, 

1 See paper by the author " On the Dangers arising from Syphilis in the practice of Dentistry." 
International Dental Journal, August and September, 1890. 



92 SYPHILIS INSONTIUM 

January 10, 1893, for the treatment of a flat papular syphilide, 
very generally diffused over the face, body, and extremities. 

Three months previously he had had what he called ' ' a pimple " 
on the left cheek, near the corner of the eye, just below the malar 
prominence ; this he had squeezed, and it refused to heal. It 
gradually became large and hard, and very shortly a swelling 
appeared beneath the ramus of the left jaw. 

On examination the entire surface was pretty thickly covered 
with a large, flat, syphiloderm, already becoming somewhat scaly, 
with some general adenopathy. On the left cheek near the malar 
prominence was a dull red mass, somewhat oval, nearly an inch 
in its longest diameter, with the surface glazed, and presenting 
some hardness on palpation ; beneath the left jaw the glands were 
fused into a large hard mass. He was most carefully examined, 
from head to foot, and no other evidence of a primary lesion was 
found than the one described. The genital region was absolutely 
free. 

No clue could be obtained as to the probable source of infection. 

Case XCV. Chancre of left cheek. Mr. W. Q., a druggist, aged 
33, unmarried, came, on March 10, 1882, for consultation in regard 
to a general eruption of a papulo-squamous character, covering 
almost the entire body and extremities. Although he had been 
exposed he had never contracted any venereal disease, and at the 
time there was no trace of a chancre upon the penis, nor had there 
been any. But upon the left cheek there existed a sore which at 
once attracted attention and proved to be a chancre, with the fol- 
lowing history : 

He had always been shaved at a barber's shop by different 
persons, using the public brushes and cups indiscriminately. 
About two-and-a-half or three months before his visit, his cheek 
had been cut by a new barber, who, he noticed, was uncleanly in 
his habits, and who shortly left the employ. A pimple soon 
formed on the site of the injury, which was again cut from time 
to time by the razor, and the place covered with court-plaster; the 
sore enlarged, and the crust was allowed to remain upon it. 
About two weeks later, the spot had fully developed into an 
ulcer, he had a chill, followed by pains in the bones, for which 
he took quinine; he also noticed a lump under the left jaw shortly 
after the development of the ulcer, and a little later the general 
eruption appeared with which he presented himself. 



CHANCRE OF THE CHEEK 93 

When first seen there was on the left cheek, not far from the 
angle of the month, and about an inch from the angle of the jaw, 
an ulcerated mass about three-quarters of an inch in diameter, 
circular and slightly raised, and with a raw, succulent surface, in 
which many hairs still stood, partly covered with a crust; the 
lymphatic glands under the left jaw were as large as small 
almonds, and there were also some smaller ones in front of the 
neck. The entire body, scalp and limbs, were covered with a 
brownish, papulo-squamous eruption, of very characteristic ap- 
pearance. The throat was also very sore, especially the right 
side, from abundant mucous patches. 

The subsequent course of the disease was very distressing. 
The patient was obliged to conduct his drug store, with little or 
no aid at times, and the treatment was often interrupted and 
imperfectly carried out. Owing to his constant standing, he early 
had ecthymatous ulcerations on the lower extremities ; he had much 
trouble with the eyes, choroiditis, quite incapacitating him at times. 
He also had several very strange nervous attacks ; at one time on 
leaving my office he became lost, how, he never remembered, 
and was carried out of town and found himself in New Jersey ; at 
a later period he exhibited perfect locomotor ataxia, which was 
removed by active treatment; and for a period of over two years, 
while under observation, he had as severe symptoms as are often 
seen, rendering him almost helpless on several occasions, although 
his symptoms w T ould often yield fairly to well-directed and active 
treatment. The glands beneath the jaw were noted as still 
swollen, and the mark of the chancre still present on the left 
cheek six months after the first visit, or nearly nine months after 
the date of its first appearance. 

Case XCVI. Cha?icre beneath left jaw. Mr. W. R.. aged 33, 
married and the father of two healthy children, was sent to my 
office, January 21, 1893, for the treatment of a very general 
maculo-papular syphilide, which had made its appearance about two 
weeks previously; the eruption was unmistakable and involved the 
face, trunk, and extremities, the palms and soles having also hard 
papules on them. The throat had been sore for over a month, and 
he had considerable malaise, with much nocturnal headache. 

Although he admitted having been exposed in connection, he 
had never had any sore, nor was there any trace of an initial 
lesion on the penis, in the urethra, nor in the genital region. 



94 SYPHILIS INSONTIUM 

A considerable enlargement of the glands beneath the left 
jaw, of which he complained, drew attention to that region, and on 
investigation it was learned that he had had a sore just under the 
left jaw, half way between the angle of the ramus and the centre 
line of the chin. This had begun about two months previously, as 
a small pimple which he had lanced and squeezed, but which did not 
heal for a long time, it remaining hard and sore. There was still 
the remains of a circular red lesion, about half to three-quarters of 
an inch in diameter. 

In regard to the mode of infection, it was learned that he had 
been shaved on November 24, and had grown a beard since then. 
He was in the habit of playing on various violins, at his teacher's, 
and the sore was exactly where the violin rested beneath the jaw; 
but no clue could be obtained as to the exact source of the virus. 

Case XCVII. Chancre of right cheek. Mr. W. S., aged 40, a 
wine merchant, was sent to my clinic from another Hospital, Sep- 
tember 26, 1883, with the diagnosis of sycosis parasitica on his 
card, and with the note that he had been applying corrosive sub- 
limate and sulphide of zinc ointments, without benefit. 

He then had a sore patch on the right cheek, the lower edge of 
it just above the edge of the jaw, nearly an inch in diameter, and 
almost circular. It was elevated, possibly an eighth of an inch, 
its centre being partly covered with epithelial cicatrization-tissue, 
and the margin about a quarter of an inch in width, more raw ; 
the hairs had largely fallen or had been epilated, the sub-maxillary 
and sub-lingual glands were enlarged. 

No history of the source of infection could be obtained ; he had 
been shaved publicly and had noticed a papule on the cheek, which 
was shaved off, and kept increasing in size up to the time of first 
observation. As the sore had been greatly irritated, he was given 
a zinc ointment, and, although the diagnosis was recorded as chancre 
of the cheek at the first visit, the hairs were submitted to micro- 
scopic examination, which, of course, yielded negative results. 
Under the zinc ointment the crusts and epithelial covering came 
off, and most of the hairs fell out, leaving a red, raw and moist 
surface. 

Three weeks later he began to have excessive alopecia, and a 
general, small papular syphilide covered the entire surface; some 
general adenopathy also occurred, he having been without specific 
treatment. Under active medication his symptoms all yielded 



CHANCRE OF THE EYELID 95 

very rapidly, and while then under observation he had very few 
unfavorable features, except once a dimness of vision of the left 
eye, possibly from choroiditis, although no ophthalmoscopic exam- 
ination was made; there was no iritis or external evidence of 
disease. 

He was seen again later in my office, almost five years after 
his chancre, and, complaining still of dimness of vision, the eyes 
were examined by Dr. Knapp, who found a pigmentary retinitis 
from chronic choroiditis in both eyes; the sight improved very 
materially under specific treatment. 

Case XCVIII. Cha?icre of right cheek. Mr. W. T., aged 30, a 
seaman, came to my clinic on October 13, 1883, with a chancre on 
the right cheek, possibly acquired through shaving with the utensils 
of a comrade with syphilis. Unfortunately the case-paper relating 
to this case has become mislaid and details cannot be given, other 
than the record from the Hospital register given above. 

CHANCRE OF THE EYELID. 

Four cases are here recorded, three in males, all on the left 
eye, one on the upper and two on the lower lid ; and one case in a 
woman, where the history pointed to a chancre of the left lower 
eyelid, which had been removed for an epithelioma. 

Case XCIX. Chancre of left upper eyelid. Mr. W. U., a waiter, 
aged 24, was under treatment for tinea versicolor and gonorrhoea, 
when, on January 16, 1886, it was noticed that he had a sore on 
the left upper eyelid. It was situated towards the outer angle of 
the eye, sharply defined, of a yellowish-white aspect, with a raw 
surface, and depressed in the centre ; it extended from the edge of 
the eyelid almost three-quarters of an inch upwards, and was 
about half an inch in length. Under very active anti-syphilitic 
treatment, the ulcer rapidly healed, and he had very few syphilitic 
manifestations, except adenopathy, headache, and, later, asarcocele 
which was thought to be gonorrhceal, but which yielded promptly 
to an increased strength of the anti-syphilitic treatment. 

No source of infection was made out, but the man was of loose 
habits. 

Case C. Chancre of left lower eyelid. Mr. W. V., aged about 
26, applied at my clinic for the treatment of a maculo-papular 
syphilide covering much of the body. On searching for the 



96 ' SYPHILIS INSONTIUM 

primary lesion, it was discovered, seated on the outer half of the 
left lower eyelid. The characters closely resembled those pre- 
sented by the case just described, a hard, whitish-yellow ulcer, one- 
half by one-quarter of an inch in diameter, seated directly on the 
edge of the lid. The full notes of the case are mislaid, but the 
case is still very vivid in my mind, and was recently recalled to my 
attention by one of the gentlemen who saw the case with me. 

Case CI. Chancre of left lower eyelid. Mr. W. W. , aged 28, 
first noticed a small red point on the lower eyelid three weeks pre- 
vious to his visit, March 11, 1892. This had the appearance of a 
stye, and was lanced by an oculist one week before, of course 
without result ; the sore point continued to enlarge to the time of 
observation. 

When examined, the left lower eyelid was seen to be the seat 
of a tumor the size of a small chestnut, a little to the left of the 
median line, which nearly closed the eye: this was very hard, and 
on its surface there was a slight, superficial ulceration, giving it a 
glazed appearance, of a vivid red, and extending inside the lid. 
There was very marked pre- auricular glandular enlargement, and 
the sub -maxillary gland on that side was the size of a pigeon's egg. 

It was thought that possibly infection took place through a 
towel, as he was a waiter in a hotel where there were 100 waiters 
who often used a towel in common; but possibly it occurred 
otherwise. 

Case CII. Chancre of left lower eyelid. Mrs. W. X., aged 43, 
came under my care November 13, 1880, for an ulcerative syph- 
ilitic eruption on the lower part of the left leg, presenting also 
scars of other similar lesions on the left forearm and elsewhere: 
she had also an exquisite pigmentary syphilide on the neck. 

She gave no history of syphilitic infection, but on close ques- 
tioning it was learned that she had had a lesion on the left lower 
eyelid, some four years before, and her description of it answered 
so closely to the appearances presented by chancre in this locality, 
that it was believed to have been such, as it had immediately pre- 
ceded the active syphilitic symptoms ; it had been excised by some 
one for an epithelioma, after it had lasted some time. There 
existed a small superficial scar, involving about half of the lower 
lid, presenting perfectly healthy cicatricial tissue, without the 
slightest attempt at a return of the supposed epithelioma. The 
young age of the patient (^8 or 39 years at the time of the opera- 



CHANCRE OF THE CHIN 97 

tion), the perfect results after a relatively slight removal, coupled 
with the description of the original sore, seemed to leave no doubt 
but that it was the initial lesion of syphilis in her case : other cases 
are on record where chancres of the eyelid have been excised for 
epithelioma. 

CHANCRE OF THE CHIN. 

Four cases (one added since the tables were made), are re- 
corded of the initial lesion on the chin ; three of these were observed 
directly, and in the other case the history was so clear that it must 
be accepted as such, although the sore had occurred two years 
before observation. 

Case CIII. Chancre on left side of chi?i. Mrs. W. Y., aged 
36, applied on January 15, 1889, for the treatment of an ulcer 
on the left side of the chin which had then lasted nearly two 
months. 

She could give no very clear history of the formation of the 
sore, except that it had steadily increased in size from a small 
scratch or papule, until the time of her visit ; she had been treated 
at different dispensaries, and by several physicians, but the sore 
refused to heal. 

When first seen the ulcer was somewhat oval in shape, and 
rather more than half an inch in its longest diameter. The 
margin was sharply defined, and raised, but the centre somewhat 
depressed, and covered with a thin, shiny crust, beneath which 
the surface was raw and secreting; there was some adenopathy 
on that side ; it is not recorded if there was any hardness to the 
ulcer. There was a maculo-papular eruption, just appearing on 
the neck and chest, and soreness of the throat. 

Under active mixed treatment and a calomel ointment to the 
ulcer, it healed with remarkable rapidity, although the eruption 
continued to develop, and she had afterward much periosteal 
pains and headache. 

Nothing definite could be learned in regard to infection ; but her 
husband had recently returned after an eighteen-months' absence 
in Panama, with an eruption which was supposed to be syphilitic, 
and it is probable that a scratch became inoculated in kissing. 

Case CIV. Chancre on left side of chin. Mr. W. Z., aged 39, was 
sent to my office, February 6, 1892, for a very severe large papular 
eruption, which was particularly developed about the face, but also 

8 



98 SYPHILIS INSONTIUM 

very extensive on the body and limbs ; it had existed for two or 
three months. 

Some three or four months before his visit he had noticed a 
sore on the left side of the chin, three-quarters of an inch below 
the left corner of the mouth, which was accompanied with swell- 
ing of the glands beneath that side ; this was soon followed by the 
eruption. There was no chancre on the penis or elsewhere. 

The sore had healed under the treatment given previously, 
leaving a slightly depressed, oblong scar, about three-quarters of 
an inch in longest diameter, which was still considerably reddened, 
but not hard. It was supposed that infection took place through 
a razor cut, but he could never trace the source of the virus. 

The syphilis ran a very severe course. 

Case CV. Chancre on right side of chi?i. Mr. V. A., a married 
gentleman, aged 50, had not been exposed to venereal disease for 
twenty-five years, and had never had any lesions of the penis. 

Two years before his visit, September 21, 1887, he had been 
cut by a barber on the right side of the chin, but could give no 
particulars in regard to the exact source of infection. The cut 
point refused to heal and became an ulcer, which lasted six weeks, 
and finally was cured by local caustic -treatment alone, leaving a 
depressed cicatrix a third of an inch in diameter ; he stated that 
he had taken no medicine internally for twenty years and was 
not conscious of having any eruption of the body prior to that for 
which he sought relief. This eruption was first noticed about two 
months before his visit, while bathing in the sea, it appearing 
first on the right upper arm, the other points following and 
increasing up to the time of observation. 

When first seen, there was a characteristic, late, papulo- 
tubercular syphilide in the right eyebrow, on the right upper arm 
and thigh, and on the left wrist. The lesions were mostly dis- 
tributed in circles and broken curves, and were moderately scaly. 
There was tenderness of both tibiae, and some mouth lesions, 
although these were rather doubtful, as he was a great smoker. 
For the few months previous to being seen he had had pain in the 
front and top of the head, without cause. The eruptions all disap- 
peared in the course of some months under anti-syphilitic treat- 
ment, but he was seen again eighteen months later, with large 
surfaces of quite deep and ulcerated tubercular syphilis, on differ- 
ent parts of the body. 



CHANCRE OF THE HAND 99 

Case CV. {bis). Chancre on left side of chin. The following case, 
in private practice was overlooked in making up the preceding 
tables. Mr. G. F., aged 25, first noticed a pimple to the left of the 
median line of the chin, on February 22, which became sore, 
ulcerated, and lasted until May, finally healing under local treat- 
ment ; when largest the ulcer was the size of the thumb nail. At 
the same time he had great swelling of the glands beneath the jaw, 
much malaise and shooting pains, and an eruption appeared about 
four weeks after the beginning of the ulcer ; the hair then fell and 
he had sore throat later. 

When first seen, December 4, 1891, he had the remains of a 
general, large papular syphilide, with general adenopathy. The 
scar of the chin chancre presented an oval, depressed surface one- 
half by one-third of an inch in diameter. There was no lesion 
on the penis, nor had there been. 

No source of infection could be found; he was shaved fre- 
quently by a barber, but knew of no means by which he was 
infected. 

CHANCRE OF THE HAND. 

Two cases occur here, one on the back of the hand, and one 
at the base of the left thumb. 

Case CVI. Chancre of back of left hand. Mrs. V. B., aged 25, 
applied at the Skin and Cancer Hospital on September 1, 1886, for 
the treatment of a large papular syphilide, chiefly annoying on the 
forehead and cheeks, with mucous patches on the lips and tongue. 
There was also headache and alopecia. The initial lesion still 
existed on the back of the left hand, of the origin of which how- 
ever, she could give no clue. 

The history was, that two months previously a small lesion had 
appeared on the back of the hand, which was treated by her phy- 
sician with nitric acid, and had gradually enlarged, refusing to heal. 

When first seen there was a shallow, indurated ulcer, about the 
middle of the back of the left hand, circular in shape, and about 
half an inch in diameter: the eruption began to develop about six 
weeks after the appearance of the ulcer. This patient was the one 
who communicated syphilis to Mrs. Z. Z. , already mentioned (Case 
XXVI.), by means of the chancre of the lip. 

Case CVII. Chancre at base of left thumb. Mr. V. C, aged 24, 
had been rooming for several months with a young man who had 

LOFC. 



ioo SYPHILIS INSONTIUM 

been under my treatment for syphilis, when he came to my office 
on August 4, 1892, on account of an ulceration on the hand. 

Three months previously, while scuffling with his companion, 
he had struck the part against his teeth and made a cut three- 
quarters of an inch long ; the wound bled profusely, but refused 
to heal, and gradually developed into an oval ulceration, one- 
half by three-quarters of an inch in diameter. By a comparison 
with my notes of his friend's case I find that just at the time of the 
injury his lips and tongue were the seat of abundant mucous 
patches ; he had been warned against giving infection, and, being 
an intelligent student, thought that his efforts had been successful, 
until the sore on his friend's hand occurred. 

When first seen, three months after infection, the ulcer was 
beginning to heal, being covered with a crust: but it was very 
hard and sharply defined, and there was marked cubital adenopathy, 
as also glandular enlargement in the neck and elsewhere, with 
considerable sore throat, but no eruption, although some appeared 
later. The chancre healed very rapidly under mercury and chalk, 
one grain every two hours. 

CHANCRE OF THE NOSE. 

Case CVIII. Mr. V. D., aged 38, came to me, October 2, 
1888, on account of a very great soreness of the left nostril, with 
some redness and inflammatory condition of the external tissues. 

It was learned that about March 2, seven months prior to his 
visit, he had noticed a collecting and drying of mucus in the 
nostril, and had applied to a physician, by whom he had been 
treated frequently, ever since, by means of sprays and ointments ; 
but the trouble had remained and increased until he presented 
himself at my office; the external lesions had appeared about 
three weeks before his visit. He had had no internal medication, 
as his disease had not been suspected to be syphilis. 

There was then a great swelling of all of the left nostril, which 
stood open, and was covered interiorly, on its outer wall, with a 
dried crust, and on the margin there was some ulcerated surface 
free from crust ; the outside of the nose was reddened and uneven 
from small nodular masses. There was no history whatever of 
preceding syphilis, and the lesion was suspected to be a chancre, 
rather than a later manifestation of the disease, but the diagnosis 



CHANCRE OF THE EAR ioi 

was most difficult to substantiate at the first visit. He was given 
a mixed treatment with calamine and zinc ointment to be applied 
freely, outside and inside the diseased nostril. 

One week later it was noted that the change in the condition 
of affairs was very great ; much of the external redness and swelling 
of the nose was gone, and the ulcer within the nostril had healed 
over. At this visit he was carefully examined, and a fading 
maculo-papular syphilide was discovered ; there was cubital aden- 
opathy, and he afterward had mucous patches, etc. 

Two weeks after his first visit the inflammatory element had 
about disappeared from the nose, and it was recorded that the left 
ala nasi presented an ivory-like hardness, which remained dis- 
tinctly, and was noted each time when he was seen, even six 
weeks later; the ulceration of the primary lesion on the mucous 
surface of the ala, healed entirely in a few weeks from the first 
visit. 

In searching for a mode of infection, it was found that, being 
a custom-house broker, he was accustomed to be much with sea- 
men from the ships, using the same towels, etc. ; it was there- 
fore supposed that in some manner, in picking the nose, or possibly 
in wiping it with a towel, he had conveyed the poison to some 
abraded surface within or at the edge of the nostril. He knew 
of no other mode of infection, he had no lesions on the genitals, 
nor had he been exposed in sexual intercourse for two years. 

CHANCRE OF THE EAR. 

The following case of chancre of the left ear is interesting, as 
the man from whom he received the injury was known to have 
syphilis. 

Case CIX. Chancre of left ear. Mr. V. E., a printer, aged 33, 
applied at the New York Hospital, November 24, 1880, for the 
treatment of a greatly inflamed ear, which had been torn in a 
fight, three weeks previous to his visit, it having probably been 
bitten. The man with whom he had fought had early syphilis, 
with the mouth sore from mucous patches. 

The surface had been much irritated by basilicon ointment 
and other applications, and when first seen the entire left auricle 
was greatly inflamed, with crusted exudation around a large 
ulcerated surface ; the diagnosis of dermatitis was made, and 



102 SYPHILIS INSONTIUM 

palliative and soothing treatment adopted. Two weeks later it 
was noted that the lesion had spread greatly, and then occupied a 
space three inches long by two inches wide, in front of the ear 
extending down towards the lobule. The surface was ulcerated 
and irregularly elevated, with considerable tumefaction of the 
edge ; the ulcerative process extended on to the external auricle, 
which was red and cedematous, and also into the auditory meatus, 
which was occluded by the swelling. The pain in the sore was 
very great, especially at night ; it was ordered to be poulticed, 
the poultice being made with a lotion of permanganate of potash, 
and, some laxative pills containing blue mass were ordered. 

One week later the surface was suppurating freely, with large, 
florid granulations, but with an improved appearance; the pain 
was still intense at night, abating toward morning. The diagnosis 
of chancro was now made, and the poultices were stopped and a 
mild calomel ointment applied, and internally a mixed treatment 
given, with a mercurial purge. Three days later the ulcer was 
recorded as still about three inches long by two wide, with hard, 
everted borders^ but with improvement in its general appearance; 
the pain soon lessened under this treatment, and on January 5, six 
weeks after his first visit, the ulcer was "completely healed, leaving 
a red, scaly surface. A large papular syphilide had just appeared, 
covering most of the body and extremities. Later, mucous 
patches, bone-pains, and other syphilitic symptoms completed the 
history of constitutional syphilis. 

CHANCRE OF THE LEFT TEMPLE. 

Case CX. Chancre of left temple. Mrs. V. F., aged 29, who 
worked with her husband in making artificial flowers, came to the 
New York Hospital April 18, 1891, on account of a very general, 
large, flat, papular syphilide, which was particularly well devel- 
oped about the head and neck. 

The history was that about the middle of January, three 
months previously, there had appeared on the left temple a small 
pimple, which was scratched, became crusted over, the crust was 
removed again and again, and the sore beneath it increased 
in size, almost to the time of the visit. Of late it had become 
more dry, and was healing over. A few weeks after the sore was 
first noticed the general eruption had appeared. 



CHANCRE OF THE LEFT SIDE OF THE NECK 103 

On examination a dusky red, slightly raised solid patch, an 
inch or an inch and a half in diameter, was seen on the left temple, 
partly within the hairy surface ; there was not very much hard- 
ness, but the edges could be very distinctly felt, all around. The 
post-auricular and anti- auricular glands were large and hard on 
that side, and some moderate general adenopathy ; mucous patches 
in buccal cavity. Later on she had double iritis, first on the left 
side, and also alopecia, etc., the syphilis running a very severe 
course. 

In order to eliminate genital chancre I had her most carefully 
examined by the gynaecologist of the service, and no trace of a 
primary lesion could be found on the external or deepest parts. 
No clue was ever obtained as to the source of the infection, although 
she was an intelligent woman and aided me in my investigations. 

CHANCRE OF THE LEFT SIDE OF THE NECK. 

Case CXI. Chancre of left side of neck. Miss V. G. , aged 22, 
applied at the Skin and Cancer Hospital, September 4, 1891, for 
the treatment of a sore upon the left side of the neck : it was about 
the size of a walnut, rather hard, and protruding considerably from 
the surface, and with a red, slightly excoriated surface, with a 
little sero-purulent discharge. 

As the nature of the lesion was doubtful, and suggested 
strongly a small sarcomatous tumor, excoriated by the dress, she 
was given a one-per-cent watery solution of fuchsine, to be kept 
applied to the surface : there was no internal treatment given, as 
it was desired to wait for further developments. One week later 
the tumor had softened some and was less elevated. 

Two weeks after her first visit there was post-cervical aden- 
opathy on each side, and three days later still, an abundant 
macular eruption of syphilis appeared on the body : the sore on the 
neck then appeared very much better, from the use of a mild 
mercurial lotion which had been given her on her second visit, 
when the true nature of the lesion had been suspected. 

On close inquiry it was found that a few weeks before her first 
visit she had had a bee sting on the neck, which she afterwards 
scratched, and a lady friend had applied court-plaster to it, 
wetting it once or twice on her tongue ; the small point had in- 
creased then steadily in size, up to the time of the visit. It was 



104 SYPHILIS INSONTIUM 

supposed that the infection was thus given on the court-plaster, 
though nothing could ever be learned in regard to the person 
applying it. 

CHANCRE OF THE FOREARM. 

. In one case, that of a very intelligent gemleman, the evidence 
pointed very clearly to the acquiring of syphilis by tattooing on 
the arm, some years before he came under observation. 

Case CXII. Chancre of right forearm. Mr. V. H., aged 43, 
came to my office for the treatment of leukoplakia, April 19, 1883: 
he was a great smoker, and had been particularly troubled with 
the mouth and tongue during the previous year. 

When first seen there was little in the mouth to suggest any- 
thing beyond the condition often observed in those using tobacco 
excessively : the sides of the tongue, especially the right side, were 
the seat of pearly white patches, sharply defined, and there were 
also some patches on the insides of the cheeks. He denied having 
had syphilis, though he acknowledged a suppurating bubo twenty 
years before. With a diminution and occasional cessation in the 
smoking, and with a weak chromic acid solution applied locally, 
and alkalies internally, the white patches lessened very decidedly, 
and within three months had about disappeared. 

When next seen, five months later, he had a well-defined, 
though not very prominent patch of tubercular syphilitic eruption 
on the scrotum, and also one on the thigh, and it was then noticed 
that he had dark stains here and there from what he had called 
boils, and on the side of the right middle finger there was an infil- 
trated mass which cracked. He was put upon a mixed treatment, 
and the lesions disappeared quite promptly, without local measures ; 
a month later he had again a scattered tubercular eruption, this 
time on the palms. At later periods he had other scattered lesions. 
While he had previously considered himself in good health, he now 
noticed that there had been a marked improvement in his general 
condition under the use of anti-syphilitic treatment. 

After establishing the diagnosis of syphilis we endeavored on 
several occasions to trace the source of infection, without avail, 
until I noticed a tattoo on the right arm, he having been a sea- 
captain; on close questioning I learned that about seven years 
previous to his first visit he had had the tattoo replaced by an old 



CHANCRE OVER THE COCCYX 105 

sailor, as the former one had not been distinct. This second tattoo, 
he said, behaved differently from the former one, and from others 
he had seen, and was sore for some time, but his memory was not 
good in regard to the peculiar local features exhibited. Some 
three or four months after this second tattooing, he began to have 
the eruption on the palms, and he had noticed that since that date 
his tissues had behaved differently than they had previously done, 
not healing as before, when subjected to injury. 

CHANCRE OVER THE COCCYX. 

The following case exhibits the chancre in a most unusual 
locality and from a most uncommon cause. 

Case CXIII. Mr. V. I., aged 45, a gentleman with a grown 
up family, was sent to me in consultation, from a distant city, 
September 20, 1887, on account of a diffuse maculo-papular syphi- 
lide, with general adenopathy. He was perfectly positive that he 
had had no venereal exposure in any manner whatever, and was 
shocked, as well as indignant, at the suggestion of the nature of his 
disease, he having only very recently cautioned his own son against 
sexual transgressions. He had no sore on the penis, and I 
searched for a long time to find the site of entry of the poison; 
for the eruption was manifestly of such recent syphilis that I felt 
confident that the chancre, or its well-marked remains, must be 
still present. The lips and cavity of the mouth were examined 
in vain, as also the fingers, and all other portions where one might 
expect to find such a sore. 

On questioning still further, as to whether he had not had 
some ulcerating spot on any portion of the body, he then called 
my attention to the sacral region, where he said he had had a sore 
point for a number of weeks, which had been regarded as a simple 
ulcer, or as an epithelioma by his family physician ; it had, how- 
ever, been diagnosed as a chancre by a surgeon of prominence in 
another city, just before his visit, as the eruption had then just 
appeared. On examining the site, there was found an ulcer just 
within the fold of the nates, about an inch back of the anus. When 
the parts were separated,' the ulcer was round, about half an inch 
in diameter, sharply defined, with red edges and a greyish-white, 
slightly ulcerating base ; a distinct hardness could easily be made 
out. This patient was seen again in consultation, some eight 



io6 



SYPHILIS INSONTIUM 



months after his first visit, and was still suffering from syphilitic 
lesions, mainly in the month. 

The supposed and probable mode of infection was very inter- 
esting. The patient stated that he had long had some itching in 
that region, even for years, and at times there would be a little 
fissure along the crack between the nates, which, he said, existed 
also just before the new lesion developed. Some five or six weeks, 
perhaps longer, before his visit to me, he had been in bathing, 
and, quite contrary to his usual custom, he had worn a strange 
suit of bathing clothes; moreover, on account of the itching 
in that region he had rubbed and scratched the part vigorously 
through the bathing trousers. A few weeks after this an attend- 
ant in a bath had noticed the ulcer forming, which had persisted 
and increased in size up to the time of his visit. 

The supposition is that some one, who had worn the bathing 
suit before him, had secreting mucous lesions about the anus, 
and had left the clothing soaked with the virus; this was then 
very thoroughly rubbed upon the already existing fissure, in the 
effort to obtain relief from the itching, by rubbing and scratching 
through the clothing. A more perfect opportunity for artificial 
inoculation could hardly be presented. 



CHAPTER V. 

DEMOGRAPHY OF SYPHILIS. CAUSES AND METHODS OF THE SPREAD OF 

SYPHILIS IN THE PAST AND PRESENT. A. SYPHILIS PANDEMICA 

(INCLUDING SYPHILIS EPIDEMICA and endemica). 

B. SYPHILIS SPORADICA (INCLUDING SYPHILIS 

ECONOMICA, BREPHOTROPHICA, 

AND TECHNICA). 

The virus of syphilis is one of the most energetic and certain 
of animal contagions, and exerts its powers whenever and where- 
ever it can find a suitable opportunity. When first introduced 
into a community, it develops and spreads in the most active 
manner, sparing neither age nor sex, provided it can gain access 
into the economy; this has been repeatedly shown in the past 
history of the disease, and will be more particularly described in 
the succeeding chapters. 

It will be seen later that whole families have been infected, 
when, through ignorance of the danger, all have been exposed 
alike in the intimate relations of family life, especially among the 
peasantry of certain countries, where household utensils are largely 
used in common. The reason why any escape, is simply because 
a sufficient quantity of the active contagious element of the dis- 
ease has not found access to the system through wounds or abra- 
sions ; it is questionable whether artificial inoculations would not 
invariably succeed in producing syphilis, if they were perfectly 
performed upon those who had not been previously protected by 
a former attack of the disease, or by hereditary influence, more or 
less remote. The virus resembles that of vaccinia more closely 
than any other, and it is expected that this latter can be pro- 
duced with sufficient care in every newborn infant ; the exceptions 
only serve to prove the rule. The same would undoubtedly be 
true of the syphilitic poison if tested in the same manner. 



108 SYPHILIS INSONTIUM 

Such being the case, it is not surprising that the disease has 
spread with greater or less rapidity, until, as previously stated, it 
may now be found in almost every portion of the inhabited globe, 
and appears to be still increasing, certainly in the large cities ; and 
much of this extension of the disease has taken place in later 
years, even with the increased knowledge of the pathology and 
treatment of syphilis, and in spite of the sanitary safeguards which 
have at times been thrown out against it, here and there, with 
greater or less vigor. 

The reasons for the steady spread of syphilis are not difficult 
to discover. The disease stands alone, and cannot be compared 
with any other known malady, except, perhaps, leprosy, which 
many have labored to prove to be but an ancestor or progeny of 
syphilis. Syphilis differs in very many respects from the other 
infectious diseases, such as small-pox, scarlet fever, and measles, 
in its chronic character, wherein lies the source of its great danger. 
While these latter affections may at times sweep over a community, 
and attack those who have escaped previous incursions, and pos- 
sibly a few others, the danger from those infected is ended in a 
comparatively short time ; the disease runs a definite course, and 
with proper sanitary precautions, the danger of further spread of 
the contagion is averted, and after a certain, but relatively short 
period, the individual can no longer communicate the disease. 

But with syphilis all is quite different. The patient may be 
quite ignorant of having acquired the disease, either by venereal 
relations or otherwise, until the virus has actually been in the 
system for some time ; it may even be several weeks before 
the chancre or primary sore is sufficiently developed to render 
the diagnosis certain. During a part, at least, of this indefinite 
period, it is quite possible that others may have been inoculated 
from the already slightly abraded sore. This not infrequently 
happens in extra-genital chancres, the lesion existing for a very 
considerable time, and even running its course and being com- 
pletely healed by local measures, without its true nature being 
recognized ; indeed, it is often not until the appearance of second- 
ary symptoms leads to the diagnosis of syphilis, that the point of 
entry of the poison is found to be some long-continued sore which 
has just healed. During this period any number of persons may 
have been most innocently inoculated. 

Nor is this all, for the danger has only just begun. With the 



CAUSES OF THE SPREAD OF SYPHILIS 109 

development of the secondary symptoms comes the period, often 
long extended, when the fatal mucous patches, with their virulent, 
and often abundant secretion, multiply the sources of infection 
many fold. 

The period of time during which this danger may last, has 
never been accurately determined, and perhaps never will be 
known, and undoubtedly varies in different cases ; but according 
to the best authorities it may, and frequently does, last at least 
two years, possibly for a very much longer time in particular 
instances. 

In neglected cases, these mucous patches may be very exten- 
sive, both in the mouth and elsewhere, and when patients are not 
acquainted with their danger, or are careless, they may and do 
1 furnish a prolific source of contagion ; a very large share of all 
instances of syphilis insontium derive their origin from these mucous 
patches, as will abundantly appear elsewhere. But it must also 
be remarked, that cases differ very greatly in respect to mucous 
patches, and some patients may present very few during the entire 
course of the disease, while with proper care, they may be kept in 
abeyance almost entirely. The danger is, nevertheless, ever 
present, as in Case LXVIL, Dr. and Mrs. X. O., mentioned in the 
previous chapter, where a physician who had a chancre of the 
finger, and was fully aware of the danger, finally infected his wife 
in some manner which was never recognized, possibly through 
pregnancy. 

It has often happened that those guilty of sexual transgressions 
have been the first to introduce syphilis into a community, 
whereby the disease has gained a footing, and has been spread 
alike by the guilty and by the innocent. Looked at in its largest 
sense, however, syphilis cannot, in the light of present knowledge, 
be any longer regarded as essentially a venereal disease, but as a 
scourge, ever ready to attack all who may be exposed to its virus. 
The reason why it is so commonly communicated in the venereal 
act, is, as already suggested, simply because thereby is fur- 
nished the most ready and most frequent means of intimate 
personal contact, during which abrasions of the surface of the 
skin or of the mucous membrane occur, thus affording the avenue 
through which the poison gains access beneath the epithelial cover- 
ing, and is absorbed into the system. The very common location 
of chancres upon the mucous membrane of the genitals, is also 



HO SYPHILIS INSONTIUM 

explained by the great delicacy of the tissues, and their tendency 
to become abraded, either by friction, or by balanitis or herpes 
progenitalis or other causes. 

Finally, patients affected with syphilis are more likely to com- 
municate the disease through sexual intercourse than are those 
suffering from other infectious maladies, such as small-pox, scar- 
latina, or measles, because, it being a chronic affection, and 
frequently not interfering with the daily life and avocations, they 
are, from its long period of contagiousness, in a position to trans- 
mit it to others, with whom they come in contact. If those with 
the other contagious diseases, were to commit the same acts, these 
diseases would also be communicated in like manner ; it frequently 
does happen, for instance, that scabies and the vegetable parasitic 
diseases of the skin are thus acquired, but they are never even 
then reckoned among venereal affections. 

It remains for us now to consider more particularly some of 
the instances and modes whereby syphilis has been spread to com- 
munities and individuals, otherwise than by the sexual act. 

We will first note the occasions on record, where the disease 
has affected large numbers, or even nations, in such a manner as 
to entitle it to the designation of a pandemic affection, A. Syphilis 
pandemic a. 

We will then consider B. Syphilis sporadica, where it appears 
only in isolated instances, or in small groups, as opportunities of 
infection present themselves. These subjects may be further 
sub-divided as follows, and will form the basis of the succeeding 
chapters : 

A. Syphilis pandemica. This term is applied to the disease 
where it has extended in a short time so widely as to affect many 
individuals, or even a large part of the population of any district, 
even as other contagious diseases may become pandemic ; this 
part of the subject may, for convenience of study, be further sub- 
divided into epidemic and endemic syphilis. 

i. Syphilis epidemica. In the instances to be described later 
under this designation, syphilis has spread with great rapidity, 
and has affected many persons within a comparatively short time; 
the disease has often not been recognized at the outset, but later 
the source of the infection has been discovered, and the epidemic 
arrested. 



SYPHILIS SPORADIC A ill 

2. Syphilis endemica. In other instances the progress has been 
more slow, and the disease has seemed to fasten on a people or 
nation, and to persist for a great length of time, presenting char- 
acters more or less peculiar, as will be noticed in the succeeding 
chapters. 

B. Syphilis sporadica. In the large majority of instances syph- 
ilis occurs in an isolated or sporadic manner, the virus being 
communicated to separate individuals ; it is very commonly, no 
doubt, confined to the person infected , otherwise the number of 
cases would be infinitely greater, even than at present. As 
already stated, it is not proposed to consider the venereal aspect 
of the disease, nor its transmission by heredity or marriage, and 
our further study of sporadic syphilis will relate wholly or mainly 
to syphilis insontium sine coitu, or syphilis acquired otherwise than 
by the sexual act. 

An examination of the reported instances of the sporadic 
transmission of syphilis by non-venereal means, or of syphilis sine 
coitu, shows that the modes by which the disease has been acquired 
are as varied as are the relations of life ; and yet we find that there 
is a certain uniformity in these cases, which permits of a very defi- 
nite analysis, according to the classes of persons infected, and 
the agent or means by which the virus has been communicated. 
Thus they may all be grouped in three general classes, as 
follows : 

i. Syphilis economica. Here the syphilitic poison is propagated 
among those having relations in common, through the bonds of 
common interest, in domestic and industrial conditions. 

2. Syphilis brephotrophica. In this class the disease is spread 
among infants, and those having to do with their care and nourish- 
ment. 

3. Syphilis technica. This group includes those cases where 
syphilis is communicated in connection with the various forms of 
body service, medical, surgical, or others of like nature. 

The sporadic aspect of the disease, is the one which princi- 
pally concerns us in the present study, because with the advance 
of knowledge in the recognition of syphilis, it is almost impossible 
for epidemics, in the strict sense of the term, to occur, and the 
disease is usually arrested before it has become widely extended 
in any section, or from any cause ; it will be seen later, however, 
that even within quite recent times very great ravages have 



112 SYPHILIS INSONTIUM 

occasionally been made, where syphilis has been spread in found- 
ling asylums, or by a midwife, or among glassblowers, etc. 

The earlier description of syphilis, and of the epidemics alleged 
to have been produced by it, are often very confusing, and much 
thought and ingenuity have been expended in time past in endeav- 
oring to trace the diseases which were probably confounded with 
the eruptions caused by syphilis, or which modified its appearances ; 
on the other hand, in all probability much has been ascribed to 
syphilis which had no such connection, while much that was 
caused by it was overlooked. Scabies seems to have been the 
disease which most frequently masked the lesions of syphilis, 
while it is certain that leprosy was very commonly mixed up with 
and mistaken for this disease. As a striking example of the con- 
fusion existing, it may be mentioned that quite a large volume, 1 
published in 1578, purporting to be upon epidemic and contagious 
purpura, contains descriptions of unmistakable syphilis. 

The complete demography of syphilis has yet to be written, but 
from the diligent researches of Hirsch, Lagneau, Lancereaux, 
Rollet, Rey, Mauriac, Jullien, and others, referred to else- 
where, our knowledge of the disease as it appears in different 
countries, has of late years been immeasurably increased. While 
syphilis has spread steadily, following the ■ tide of human life, 
sooner or later into almost every region, there is no doubt but that 
it has in many localities lost much of its severity, and no longer 
produces the ravages observed in early times. But as a great 
disease, ever involving new lives, and continually acting as a 
degenerating force on the human race, syphilis has lost none of 
its interest for the humanitarian, and to-day, more than ever, calls 
for sanitary restrictions, which shall diminish the number of its 
victims. 

1 Joannis Coyttari. De purpura epidemiali et contagiosa. Paris, 1578. 



CHAPTER VI. 

A. SYPHILIS PANDEMICA. 1. SYPHILIS EPIDEMICA. 

II. SYPHILIS ENDEMICA. 

As has been already shown in Chapter I. , syphilis is now a 
very wide-spread disease, existing- in almost all portions of the 
earth, in varying severity in different regions, and having existed, 
in all probability, from the most ancient times known to man. 
We will now briefly consider some of the modes by which it has 
thus become diffused, and some of the peculiar forms which it has 
assumed in different regions and among various communities. 

Literature contains many accounts of a very wide-spread exist- 
ence of syphilis in different localities, where it has at times broken 
out in such a sudden, severe, and general a manner in a community 
as to give rise to the designation epidemic syphilis, which has been 
applied to it by many writers. 

In other countries or sections the disease has spread more 
slowly and insidiously, and frequently has been recognized to be 
syphilis only after it had affected very many persons; in many 
instances the disease has seemed to present features more or less 
different according to the country and climate where it has taken 
root. To this latter the name endemic syphilis has been given. 
Under these two heads we will consider the more or less general 
extension of the disease. 

I. EPIDEMIC SYPHILIS. 

The first general spread of syphilis of which we have record, 
in a form which at all merits the name of epidemic, was 
the severe and apparently sudden outbreak, in Europe, at the 
close of the fifteenth century, of what was looked upon as a 
new disease, and in regard to which so much has been written. 



H4 SYPHILIS INSONTIUM 

As is well known, it was almost universally charged that this "new 
disease," called variously the Morbus gallicus, Mai francais, Mai de 
Naples, Mai des Espagnols, Grosse verole, etc. , was imported by the 
followers of Columbus from the new world, and was carried and 
spread by the army of Charles VIII. of France, in his invasion of 
Italy ; certain it is that the malady extended with frightful rapidity 
and manifested a severity which has hardly been equalled in any 
accounts of the disease before or since; thus, a writer in 1502, 
Sabellicus, 1 states that at that time almost one-twentieth of the 
whole population of that and the surrounding sections suffered 
from the disease. 

The extensive ravages of syphilis at this and other times, indi- 
cate its very frequent communication in an innocent manner, as 
well as through illicit intercourse; any other view would imply 
or presuppose an extent of licentiousness quite beyond the bounds 
of probability. This view is confirmed by the facts about to be 
alluded to in regard to subsequent sudden developments of syph- 
ilis in different localities, the instances given being largely, and 
in many instances wholly, non-venereal. 

Since the date referred to, the number of occasions in which 
syphilis has occurred in epidemic form, to a greater or less extent, 
could hardly be imagined by one who has not especially considered 
the subject, and as the research extends, the number of instances 
multiply almost beyond belief. The following table shows a 
number of these epidemic outbursts of the disease, arranged chron- 
ologically, giving such data as may be of interest in connection 
with the same ; the items of this table will be more particularly 
dwelt upon later in connection with the various modes of acquir- 
ing syphilis insontium. 

No attempt has been made to include all the smaller groups of 
cases, sometimes spoken of as localized epidemics, in this table 
but some of them are placed with the larger epidemics to show 
the order in which the different methods of the innocent communi- 
cation of syphilis have been recognized in different countries. 

The references to all these, and also to other instances of the 
sudden outbreak of syphilis, may be found in the Analytical Bibli- 
ography at the end of this work, and the modes of infection clas- 
sified in the Synopsis of Facts and Literature. 

1 Sabellicus: cited by Lancereaux. A treatise on Syphilis. Sydenham Edit. Vol. i, 1868, p. 24. 



EPIDEMICS OF SYPHILIS 



"5 



TABLE VI. 

EPIDEMICS OF SYPHILIS 

Chronologically Arranged.* 

First Period, 1577-1654: Central Germany and Switzerland. 

Chief Source, Cupping. 



Date. Locality. 


Reporters. 


Source of Infection, etc. 


Number Infected, 
etc 


1577 


Brunn. 


Tordanus. 


Cupping, bloodletting by wet-cups 


180 in the town : 




(Moravia) 


Sporisch. 


and scarificators, in public, by the 


others from out- 


(1) 


Austria. 


Ozanam. 


town barber — virus conveyed by 
unclean cups, etc. 


lying districts. 




Zurich, 


Records of 


Cupping, sheltering wayfarers, 


No figures. 




Switzerland. 


the Canton. 


and other modes. Authors cite Meyer- 




(2) 




(Meyer- 
Ahrens, 
Behrend's 
Syphilid- 
ologie). 


Ahrens, in regard to an episode at 
Zurich, 1592; but it is evident from 
numerous prophylactic enactments 
on record that this was but one of 
manv epidemics before and after 1592, 
which were not confined to Zurich 
alone. 




x 596 


Altorf, 


(Soldius). 


Cupping, phlebotomy, etc. but not in 


Very many; in one 




(Bavaria) 


Hornung. 


public ; apparently from house to 


place mention is 


(3) 


Germany. 


(Lammert). 


house, by itinerants ; cases occurred 
over a large district, — no particular 
foci, — and the disease prevailed for 
three years (1596-1599), probably un- 
explained. 


made of over 100. 


J599 


Nuremberg, 


Town- 


Cupping— Sei/z, the town bathmaster, 


Over 70 infected. 


(Bavaria) 


archives. 


cupper, etc., was prosecuted and 




(4) 


Germany. 


(Endter). 
Lammert. 


punished by the town for allowing his 
clients to become infected through 
cupping. 




1603 


Bamberg, 


Snit?er. 


Cupping — in all respects a duplicate of 


No figures : but 


(0) 


Bavaria. 


Lammert. 


No. 4. 


many infected. 


1608 




Bourgeois. 


Accouchement— very few particulars, 


35 families in- 






(Rosen de 


at second-hand. 


fected. 


(«> 




Rosenstem). 






161s 


Sommerach, 


Original 


Cupping— another instance similar to 


14 are prominently 




Franconia. 


(Court) 


the Nuremberg and Bamberg epi- 


mentioned. 


(7) 


(now Bava- 
ria) 


archives. 
Geigel. 


sodes. 




1624 


Windsheim, 


Widmann. 


Cupping — not stated if from public 


70 or more. 


(8) 


Bavaria. 


Horstius. 


bath, or from itinerant cuppers. 





1 The references to the source of information will be found in the Analytical Bibliography, at the 
end of the work, unckr. the name of the Reporter here given. 



n6 



SYPHILIS INSONTIUM 



TABLE VI. {Continued). 

Second Period, 1654-1800 ; Over Most of Europe. 

Chiefly connected with reproduction of the race } as Breastdrawing* 

Lactation, Accouchement, Hand-raising of Children, etc. 



Date. 


Locality. 


Reporters. 


Source of Infection, etc* 


Number Infected, 
etc. 


1654 
(9) 

1- 


Middle- 
bourg, 
(Seeland) 
Holland. 


Everardus. 


Breast-drawing— a woman infected 
many others, recently delivered ; 
these infected their nurslings ; the 
latter infected those who tended and 
hand-fed them, etc. 


Very many ; Ev- 
erardus alone 
treated over 100. 


§(10) 

O 

•a 


Sorrento, 

(Naples) 

Italy. 


Musitanus. 


Hand-raising a foundling, which, 
congenitally syphilitic, was adopted 
into a convent, and tended and fond- 
led by the Sisters, many of whom 
became infected. 


No figures. 


0. 

u 

3 


(Not Stated) 


Vercelloni. 


Lactation — a congenitally syphilitic 
infant was wet-nursed by some com- 
passionate ladies ; the disease was 
spread, at first by lactation "until 
the whole village was infected." 


No figures. 


1727 

(12) 


St. 

Euphemie, 
France. 


Bayer. 


Accouchement— a midwife, first her- 
self infected digitally, transmitted 
syphilis to many of her clients, these 
to their families. 


50 parturient wo- 
men together 
with 30 or more 
in their fam- 
ilies. 


1728 
(13) 


Cork, 
Ireland. 


Barry. 


Breast-drawing— a small episode ; 
some of the infected women transmit 
the disease to their infants. 


No figures. 


J 737 
(14) 


Hungary. 


Fuchs. 


Accouchement— like No. 12; no further 
data. 


No figures. 






Alberti. 


Breast-drawing— said to be related 
in an essay not accessible, entitled 
" De osculo morbifero et morbifico." 




1746 
(15) 




No figures. 


1752 
(16) 


Nerac, 
(Lot et 

Garonne) 
France. 


Raulin. 


Lactation — infected nursling; nursing 
mothers received the disease, and con- 
veyed it to their families ; epidemic 
known as " Pian de Nerac." 


40 Nurses and 
nurslings : and 
members of 
families. 


1770 
(17) 


Leeds, 
England. 


Hey. 
(Lawrence). 


Breast-drawing— a blind woman, first 
professionally infected, in turn infect- 
ed her clients — only a few cases given. 


Not known. 


1775 
(18) 


Paris. 


Gardane. 
(Plouquet). 


ACCOUCHEMENT— a midwife, first pro- 
fessionally infected, infected her 
clients. 


No figures. 


(?) 
(19) 


Stockholm. 


Bilguer. 
(Rosen de 
Rosenstein). 


Breast-drawing— said to be like the 
episode of Everardus, but no par- 
ticulars. 


8 infected. 


1800 
(20) 




Heinecken. 


Breast-drawing. 


No figures. 


1844 
(21) 


Montmor- 

enci, 
(Seine et 

Oise) 
France. 


Portal. 
(Lugol). 
(Moraud and 
Lassonne). 


Lactation — a supposed prevalence of 
scrofula among nurslings, led to an 
investigation, and most of the nurses 
were found to be syphilitic. 


No figures. 



EPIDEMICS OF SYPHILIS 



117 



TABLE VI. {Continued). 

Third Period, 1800-1858 ; Largely i?i Ce?itral Eiirofie. 

In addition to Modes of Commu?iicatio?i recorded in the Second Period, are 

found Epidemics from Vaccifiation, Circwncision and Venesectio7i. 



Date. Locality. 


Reporters. 


Source of Infection, etc. 


Number Infected, 
etc. 


1804 Groningen 


Munninks. 


Breast-drawing — subject of a mono- 


No figures. 


j (town and 




graph, but data not accessible, at 




(22) province), 




either first or second hand. 




Holland. 








1805 Krakau, 


Rust. 


Circumcision— the fact of the myste- 


No figures — nu- 




Poland. 




rious occurrence of syphilis in male 


merous cases 


(23) 






Hebrew infants, healthy at birth and 
of healthy parents, led to the discov- 
ery of this mode of transmission ; in 
this case the psylle or mohel had 


probably in 
scattered foci. 
















syphilides in the mouth. 




1805 


Villages in 


Wendt. 


CrRCUMCisiON— this mode of commu- 


No figures : but 


j Silesia, 




nication was recognized by Wendt at 


victims numer- 


(24) Prussia. 




about the same time as above, several 
small episodes occurring. 


ous. 


i8ti jVillage in 


Wendt 


ACCOUCHEMENT — not different from 


Over 50 infected. 


1 Silesia, 


(Walch). 


previous episodes. 




(25) , Prussia. 








(?) Rhine pro- 


Rust and 


Circumcision — the cases in Silesia 


No figures. 


1 vinces of 


Jaffe. 


and Krakau were only a portion of the 




(20) Germany : 




known victims : soon after, cases in 






towns in 




some of the Rhine provinces led to an 






Polandand 




official investigation : while other epi- 






Austria. 




sodes occurred in Warsaw, Wilna, and 
Lemberg. 




18x4 


Udine, 


Marcolini. 


Vaccination —first authentic cases: 


No figures : but 




Austrian 


Barbantini. 


vaccinifer had inherited svphilis : 


nearly all in- 
fected. 


(27) 


Italy or 




forty vaccinated and a number in- 




Lombardy 




fected. 




1816 


Andernach. 


Klein 


Vaccination — began as vaccino-syph- No figures. 


1817 




(Ruthen- 


ilis and continued through domestic 


(28) 




burg). 


infection. 




1821 


Cremona. 


Cerioli. 


Vaccination— like No. 28. 


40 directly in- 


(29) 

1823 


Lombardy. 






fected. 


Two com- 


Settegast 


Lactation— prevailed some time as an 


No figures. 


munes in 


(Hacker). 


endemic. 




(30) j Coblenz, 








1 Rhenish 








Prussia. 


| 






1825 jConde 


Bourgogne. 


Breast-drawing and Lactation — 


12-14 by breast- 


1 (Cotes du 


(Fournier). 


nursing mothers infected by first 


drawing : 5 


(31) i Nord), 




method, nurslings, other nurses and 


nurses by lacta- 


| France. 




their nurslings by second method. 


tion ; many in- 


1826 








fants. 


Wilbedessen 


Diisterdorf. 


Lactation — a strange nursling, bas- 


23, mostly nursing 


|(West- 


(Hufeland). 


tard of «-t soldier, brought to the vil- 


women. 


(32) i phalia) 




lage by its mother, who could not 




'Prussia. 




nurse it : the nursing-mothers suckled 
it. 





n8 



SYPHILIS INSONTIUM 



TABLE VI. {Continued). 
Third Period (Continued). 



Date. 


Locality. 


Reporters. 


Source of Infection, etc. 


Number Infected, 
etc. 


1828 
(83) 


Chavanne- 

Lure, 
(Haut- 

Saone), 
France. 


Flamande. 
(Roller.) 


Domestic — eating and drinking ves- 
sels : spread mostly among families 
allied by blood to the people first in 
fected : a soldier brought the disease 
to the first family. 


25 and more 
infected. 


1830 
(34) 


Fredricks- 

borg, 
Denmark. 


Ewertzen. 


Vaccination vaccmifer syphilitic ; 
all the vaccinnees infected except one 
midway in the line. 


7 infected. 


1832 
(35) 


Villages in 
Schleswick 


Prehn 
(Bolsch- 
wing.) 


Sheltering Wayfarers— a man with 
fresh syphilis crossing the country 
afoot, sharing board and bed with 
hospitable people, infected some of 
the latter, who diffused the disease. 


No figures. 


1833 
(36) 


Krakow. 


Bierkowski. 


Circumcision : over 100 infants in- 
fected. 


Over 100. 


1837 
(37) 


Villages in 
Sicily. 


Gulli. 


Domestic — means not stated : the ar- 
rival of cholera did away for the time 
with police surveillance of prostitu- 
tion. Syphilis then spread rapidly 
and many families were innocently 
infected. 


No figures. 


(?) 
(38) 






Circumcision — several episodes are 
known to have occurred between 1830- 
1840, but no data can be furnished. 




About 
1840 
(39) 




Brecker. 
(Jaffe.) 


Circumcision. 


Many infected. 


1841 
(40) 


Grumello, 
Lombardy 


Tassani. 


Vaccination— usual features : moth- 
ers, nurses and others indirectly in- 
fected : 56 vaccinated, 35 infected and 
from these mothers and nurses. 


64 in all, of these 
46 directly. 


1841 
(41) 


R , near 

Luxeuil 
(HautSaone) 
France. 


Alies. 


Vaccination— (?) causes obscure : pre- 
vailed two years, and chief lesions 
genito-anal condylomata. 


Nearly 80. 


1844 
(42) 


Norway. 


Hjort. 


Domestic— six families who were allied 
by blood and marriage visited the 
clinic in a body. 


21 infected. 


1847 
(*3) 


Cologne (?) 

Rhenish 

Prussia 


Canetta. 


B R E A s T-DRA wing — particular i un-l 32, directly inf ect- 
known. | ed. 


1849 
(44) 


Coblenz, 
Rhenish 
Prussia 


Wegeler. 


Vaccination — revaccination from a 
healthv child vaccinated for the p xr- 
pose, from a syphilitic : the vaccinifer 
was not infected : the vaccinees were 
infected from its vesicle. Operator 
veterinary surgeon fined by a tribunal 


19, directly infect- 
ed, others indi- 
rectly. 


1852 

(45) 


Frienfels, 
Bavaria. 


Heine. 


Vaccination — small episode: usual 
features : operator Hiibner, a homoeo- 
pathic physician, fined by a tribunal. 


S, directly infect- 
ed. 


1853 
(46) 


Alsem- 

bourg, 
\ Belgium. 


Joly. 


Breast-drawing— a nurse, infected by 
a foundling, infects her 10-year-old 
son, who drew her breasts, — the son 
infected a number of nurses, resulting 
in a lactation-epidemic. 


No figures : could 
not be less than 
a dozen, perhaps 
many more. 



EPIDEMICS OF SYPHILIS 



II 9 



TABLE VI. {Continued). 
Third Period (Continued). 



Date. 


Locality. 


Reporters. 


Source of Infection, etc. 


Number Infected, 
etc. 


About 

1855 
(47) 


Rochecho- 
nart (near 
Limoges), 

(Haut- 
Vienne), 

France. 


Bleynie. 
(Bardinet). 


Accouchement — peculiar mode : new- 
born children only victims. Midwife 
applied her infected saliva by aid of 
fingers to stump of cord ; her object 
being to recover the "lost cord," or 
to arrest hemorrhage. 


No figures : but 
very many. 


1856 
(48) 
1857 
(49) 


Molise and 

Lupara, 
Naples. 


Marone, 
(Bouvier). 


Vaccination — special features ; tube- 
virus used, and numerous indirect 
transmissions. 


23, direct— 
ir nurses, many 
others. 


Rufino, 

(Tuscany), 

Italy. 


Galligo. 


Vaccination — no especial features. 


14, directly infect- 
ed. 


1857 
<50) 


Capistrello, 
(Abruzzo 
Ultra), 
Naples. 


Government 
Report : 
Demarchi 
and Tan- 
turri (Rug- 
giere). 


Lactation — an infected wet-nurse 
brought the disease to the place, 
where it gained a footing by lacta- 
tion ; it then existed endemically for 
8 years, spread chiefly by domestic 
contagion, and rendered a tenth of 
the inhabitants syphilitic. 


300, in round num- 
bers. 



Fourth Period, 1858-18Q2: Over the Whole World. 

Beside the features in the Third Period there is a reappeara?ice of 

Cupping as a mode of infection ; and ?iew modes, 

Glassblowing, Tattooi?ig, etc., etc. 



Date. 


Locality. Reporters. 


Source of Infection, etc. 


Number Infected, 
etc. 


1858 
<S1) 


Hakola, 
Finnland. 


(Hjelt.) 


Cupping — unlike the ancient cases, the 
operator is an itinerant, female, her- 
self infected, and is believed to be the 
source of the infection, through 
cleansing the cups with her saliva. 


200, in round num- 
bers. 


1858 
<52) 


Topparla 
Finnland. 


Hjelt. 


Cupping — same nature as the preced- 
ing. 


80 to 90 infected. 


1858 
(53) 


Gratz 

(Styna), 

Austria. 


Petry. 


Tattooing— soldiers infected by a 
syphilitic tattooer. 


9 infected. 


i860 
(54) 


Uleaborger 
Finnland. 


Hjelt. 


CUPPING — same features as Nos. 51 
and 52. 


20 to 30 infected. 


1861 
(56) 


Rivalta 
(Piedmont 

Sardinia), 
Italy. 


Pacchiotti. 

(Cerisi.) 


Vaccina! ion — usual features: de- 
scribed more minutely than any be- 
fore. 


80, in all— 46 chil- 
dren : 26 nursing 
women. 



120 



SYPHILIS INSONTIUM 



TABLE VI. {Continued). 
Fourth Period {Continued). 



Date. 


Locality. 


Reporters. 


Source of Infection, etc. 


Number Infected, 
etc. 


1862 
(56) 
(57) 


Premezzo 

and 

Castellanza. 


Ricordi. 


Hand-feeding of Infants.— two sim- 
ilar, small epidemics. 


9 in one, u in the 
other. 


1862 
(58) 




Otterson. 
(Foster.) 


Vaccination — troops in the Union 
army dtiring the civil war ; 300 vac- 
cinations, of which only 80 succeeded. 


Most of the 80 di- 
rectly infected. 


1862 
(59) 


Rive de Gier 
(Dep't. d. 

Soire), 
France. 


Viennois. 
(Guinand.) 


Glass-blowing — simultaneous infec- 
tion of the workmen. 


20, directly infect- 
ed, others in 
their homes. 


1862 
(60) 


Torre del 
Buse (near 
Bergamo), 

Lombardy. 


Quarenghi. 

Adelasio. 

Viennois. 


Vaccination— tube-virus : those indi- 
rectly infected outnumbered the 
others. 


24 ; of these only 
5 from vaccina- 
tion. 


1862 
(61) 


Csomad, 
Hungary. 


Glatter. 


Vaccination— the operator, a midwife, 
infected in her calling, infects some- 
how the vaccinifer, her nephew. 


72, direct. 


1863 
(62) 
(63) 


Cazorezzo 
and Ubaldo. 


Ricordi. 


Lactation — two precisely similar epi- 
sodes in which Q) a foundling infects 
its wet nurse,(2) she infects other nurs- 
lings, (3) these infect other nurses, 
and so on to five sets of victims. 


24 and 18, respect- 
ively ; 42 in all. 


1863 
(64) 


Near Milan. 


Ricordi. 


Breast-drawing — usual features: 
nursing-women infected, and in turn 
infect their nurslings. 


10 or 12 infected. 


1863 
(65) 


Faymoreau 
(LaVende) 
France. 


Guinand. 


Glass-blowing— few details known. 


No figures. 


1863 
(66) 


Fort Smith, 
Arkansas. 


Bennett. 


Vaccination— soldiers inoculated 
from pustules upon one another. 


"Hundreds." 


1864 
(67) 


Marcalle. 


Ricordi. 


Lactation— same features as Nos. 62 
and 63. 


16 in all. 


1865 
(68) 


Rovello. 


Ricordi. 


Lactation— same features as Nos. 62 
and 63, except mode of origin un- 
known. 


14 (nurses and 
nurslings). 


1865 
(69) 


London. 


Dunn. 


Vaccination. 


53 infected. 


About 
1866. 

(70) 


(?) 


Jones. 
(Foster.) 


Vaccination — a great number of sol- 
diers in the 12th and 16th Georgia 
regiments vaccinated them selves 
from a syphilitic comrade, choosing 
the worst looking pustules for the 
purpose ; many were infected- 


Over 100. 


1866 
(71) 


(?) 


Jones. 
(Foster.) 


Vaccination — on another occasion, 52 
soldiers, vaccinated from an infected 
sailor, became syphilitic. 


52 infected. 


About 
1866 

(72) 


Greenville, 
(Tennessee) 
U. S. A. 


Jones. 
(Foster.) 


Vaccination— a Colonel in the Confed- 
erate army, seeking in vain to be suc- 
cessfully re-vaccinated, at last be- 
came inoculated with syphilis : many 
soldiers and sailors, eager to benefit 
by the supposed good virus, were in- 
occulated from an ugly looking sore 
on the officer's arm, and a number be- 
came syphilitic. 


No figures : but 
numerous. 



EPIDEMICS OF SYPHILIS 



TABLE VI. {Continued). 
Fourth Period {Continued). 



Date. 


Locality. 


Reporters. 


Source of Infection, etc. 


Number Infected, 
etc. 


About 

1866 

(73) 


(?) 


Hubbard. 

Jones. 

Foster. 


VACCINATION — great numbers of Fed- 
eral volunteers and citizens appeared 
to receive svphilis through virus ob- 
tained from'Southern deserters, which 
was certainly not vaccine. 


' Hundreds." 


1866 
(74) 


Aikin, 

(So. Caroli- 
na), 
U. S. A. 


Percival. 

Jones. 

Foster. 


Vaccination— one hundred and fifty 
people of all ages, who had been vac- 
cinated from a man with early syph- 
ilis, or from one another (93 revaccina- 
tions), were examined about the same 
time, and each presented a vaccine 
chancre in situ, with secondary symp- 
toms, and were cured by specific 
treatment. 


150 infected. 


1866 
(75) 


Auray, 

Morbihan, 

France. 


Depaul and 

Roger. 
Closmadeuc. 


Vaccination — performed by a mid- 
wife : 130 to 140 vaccinees : of these 
only a portion seen, but nearly all of 
these were infected. 


44 known to be in- 
fected. 


1866 

1867 
(76) 


Cardeillac. 


Clary and 

Guary. 
(Fournier.) 


Vaccination— of 22 vaccinated from 
one child, 13 acquired syphilis — 2 of 
these cases communicated chancre of 
breast to a mother and a wetnurse. 


13, and 2 chancres, 
breast, from lac- 
tion. 


1867 
(77) 
(lb) 


Astragal 
and 
Calibera, 


Cantilona. 


Lactation — infected nursling, from 
Trieste. 


50 infected. 


1867 
(79) 
(80) 


Castella- 
fiume and 
Roccaviva, 

Lower Italy. 


Tanturri. 


Lactation — a special investigation by 
T. of remote effects of former epidem- 
ics: the first was found to be an exten- 
sion of No. 50 : the second had been en- 
demic for 20 years, and was known as 
" sheep-pox." 


No figures. 


1867 
(81) 


Vienna, 
Austria. 


Von Pitha. 
(Jaffe.) 


Circumcision — not known if from a 
single focus, or collated statistics. 


Over 30 infants. 


1868 
(82) 


Montlucon 
(Dept. 

Allier), 
France. 


Dechaux. 
(Guinand.) 


Glass-blowing — investigated at the 
time by Dechaux. The same, two years 
later had added over 13 victims by ex- 
tension of the original malady. 


17, in all (11 work- 
men, 5 wives). 
Later report, 
over 30 in all. 


1868 
(83) 


Montecatini 
di val di 
Nievole, 

Tuscany, 

Italy. 


Balducci. 


Lactation— a number of nursing 
women had been infected by nurs- 
lings adopted or received from the 
Florence Foundling Asylum : here, as 
in the preceding, it is not clear 
whether the total is from epidemic or 
statistical aggregation. 


11 nurses men- 
tioned. 


1869 
(84) 


Schleinitz 

andSt.Veit 
(Styria), 
Austria. 


Kocevar. 


Vaccination — an episode not unlike 
that of Rivalta, No. 55. 


66 in all (31 vac- 
cinees, 19 moth- 
ers, 11 other chil- 
dren, etc). 


1870 
(85) 


Fiume, 

Austrian 

Italy. 


Mori. 


Vaccination— Nothing unusual. 


35, directly infect- 

"" ed. 


1870 
(86) 


Paris. 


Fournier 
and others. 


Eustachian-Catheterization : for 20 

years, the office of Dr. B.— an otolo- 
gist, was a focus for disseminating 
syphilis among his patients. 


Over 70 known to 
be directly in- 
fected. 


1872 
(87) 


Tavastehus, 
Finnland. 


Hardh. 


Cupping— same features as Nos. 51 and 
52- 


14 or more. 



122 



SYPHILIS INSONTIUM 



TABLE VI. (Continued). 
Fourth Period {Continued). 



Date. 


Locality. 


Reporters. 


Source of Infection, etc. 


Number Infected, 
etc. 


1873 
(88) 


Bardellaand 
Bergona. 


Granciniand 
Dall ' Acqua 
(Sormanni.) 


Vaccination. 


No figures. 


1873 
(89) 


Alexandria. 


Peola. 


Vaccination. 


16, directly. 


1873 
(90) 


Abo, 
Finnland. 


Spoof. 


Cupping— like No. 87. 


17 or more. 


1873 
(91) 


Brive 
France. 


Bardinet. 


Accouchement — midwife, who had 
been professionally infected : the first 
report gave 34 victims, only 15 being 
parturient women— a special investi- 
gation later revealed a far wider ex- 
tension : some of the newborn ap- 
peared to be infected by the midwife. 


Over 100. 


1876 
(92) 


Lebus 
(Branden- 

berg), 
Prussia. 


Freund. 


Vaccination — school-girls were re- 
vaccinated. 


15 girls. 


1878 
(93) 


Philadelphia 
U. S. A. 


Maury and 
Dulles. 


Tattooing — soldiers infected by a 
syphilitic tattooer. 


15 victims. 


1879 
(94) 


Paris. 


Josias. 


Tattooing— like the preceding. 


9 infected. 


1879 
(95) 
(96) 


London. 


Hutchinson. 


Vaccination— two epidemics, in which 
11 and 10 respectively were infected. 


21 infected. 


1880 
(97) 


Tourcoring, 
Dept. du 
Nord, 

France. 


Anonymous 
(Leloir.) 


Breast-drawing— usual features. 


20, in all. 


1881 
(98) 


Algiers. 


Desjardins 

and 

Fonvielle. 
Layet. 


Vaccination — French and native sol- 
diers : one vaccinifer. 


58 infected. 


1883 
(99) 


Aalborg, 
Denmark. 


Heiberg. 


Glass-blowing— like the French cases, 
as far as known. 


9, directly infect- 
ed. 


1883 
<100) 


Near 

Sheffield, 
England. 


Hime. 


Accouchement— 30 married women in- 
fected by a midwife, 9 husbands then 
infected by their wives, and also two 
infants. 


41 in all (30 women, 
9 men, and 2 
newborn). 


1883 
<101) 


England 


Booth. 


Accouchement— midwife with chan- 
cre of finger infected a great many 
lying-in women, who in turn gave 
the disease to their husbands and 
children. Tried and condemned to 
twelve months at hard labor. 


A great number. 


1886 

<102) 


Konigsburg, 
Prussia. 


Burow. 


EUSTACHIAN-CATHETERIZATION-small 

episode, common source. 


6 in all. 


1886 
(103) 


London. 


Macnamara. 
Hutchinson. 


Circumcision— transmitted by the un- 
suspected means of the lint, etc., in 
the box used for preserving the 
prepuce. 


7 infected. 



EPIDEMICS OF SYPHILIS 



123 



TABLE VI. {Continued). 
Fo u rth Pe riod ( Con tin ued). 



Date. 


Locality. 


Reporters. 


Source of Infection, etc. 


Number Infected, 
etc. 


1886 
<104) 


Wjatka, 
Russia. 


Tepljaschin. 


Application of tongue to eye— by 
a female practitioner, herself infected 
from a client ; to remove foreign 
bodies and heal trachoma. Numer- 
ous chancres of eyelids demonstrated. 


68, total (34 di- 
rect). 


1886 
(105) 


(?) 


Wilcox. 
(Arthur.) 


Tattooing— usual features. 


26 infected. 


1888 
(106) 


London. 
Russia. 


Barker. 


Tattooing — operator with mucous 
patches in mouth, wet the needles with 
his saliva. 


12 soldiers. 


1889 
(107) 


Dutschinski. 


Accouchement : in total population 
of 316, 36 infected (13 males and 23 
females. 


36 infected. 


t8go 
(108) 


Russia. 

Russia 
(5 rural 
districts). 


Poliataieff. 


Cupping : wet cupping by peasant wo- 
man producing chancres on the back. 


11 infected. 


1891 
(109) 


Jarotsky. 


Domestic : 2 small epidemics intro- 
duced by dry nurses -a laborer in- 
fects 8 of a family innocently. 


8 and more. 


1892 
(110) 




Blauchet. 


Eustachian-Catheterization — a 1 1 
by the same operator. 


27 cases infected. 



Numerous other small epidemics might be added to this Table 
which would be mere repetitions of those already mentioned; 
many of them, however, being inferior to those given, by reason 
of lacking some feature in the accuracy of facts, or in reporting. 
It is not desired to give more small episodes of one kind than is 
necessary to illustrate the mode of transmission; otherwise, many 
small epidemics from lactation, breast-drawing and circumcision 
would be presented, such as those found in the writings of Dron, 
Pellizzari, Taylor, Matlakowski, Kedotoff, and others. 

Tt will be seen from this table that these occasions of the sudden 
spread of syphilis to a number of persons, forming miniature epi- 
demics, each of which might have extended even more widely if 
the cause had not been recognized and removed, had as their basis 
or foundation, no less than a dozen different processes or opera- 
tions, beginning with cupping and ending with Eustachian cathe- 
terization. It will be further seen that the total number of actual 
cases mentioned in this table, taking the lowest figures named in 
each instance, is considerably over 3,000 individuals affected; this 
number is, moreover, quite exclusive of those referred to in the 
statement oO frequently made that a large number were infected, 
no actual figures being given. When we further consider that 



124 SYPHILIS INSONTIUM 

these are only some of the accessible reports which have been 
published; and also that it is improbable that even more than a 
share of the instances of such epidemics have ever appeared in 
print ; and finally that only a portion of the individuals ultimately 
infected could ever be counted, it can readily be understood how 
wide has been the spread of syphilis by innocent means, how 
many, many thousands have been the sufferers from syphilis inson- 
tium appearing now and again in epidemic form. 

II. ENDEMIC SYPHILIS. 

Syphilis may be said to be endemic now in almost every 
nation and race on the globe, but in different degrees in 
various localities ; in some sections and races it has presented, 
and even to the present day exhibits, characters more or 
less peculiar, which have been and still are known by quite 
different names ; these phases of the disease, moreover, have been 
and are } r et considered by some writers to be entirely distinct 
maladies. In reality, however, syphilis is undoubtedly one disease, 
the world over, and, under proper circumstances, runs a more or 
less similar course and presents analagous phenomena. The 
poison is one and the same, lurking here and there,- only awaiting 
the proper soil in which to germinate and nourish anew. 

Endemic syphilis has resulted both from the continuance of the 
disease in a community, in a more or less masked and sporadic 
form, after and from epidemics such as have just been mentioned, 
and, also from the gradual and slow introduction of the poison by 
chance persons and methods, at times when the extending influ- 
ence has been slight, and the circle affected has been more or less 
limited. But in one way and another syphilis has been propa- 
gated in different localities until large numbers have been inf ected, 
and until its manifold manifestations in various countries and 
among different people have finally been recognized and isolated 
from other diseases under particular names, relating very com- 
monly to the place where the malady first appeared or where it 
was first recognized. 

In many instances the true syphilitic nature of these epidemics 
and of the endemic diseases of different countries, as they have 
been called, have only been determined in later years, and it is 
more than likely that the future will still further develop the 



ENDEMIC SYPHILIS— SIB BENS 125 

subject. It is to be remembered that while earlier writers were 
frequently most careful observers and very accurate recorders, 
the synthetic knowledge of syphilis is of relatively recent date, 
and it is highly probable that yet greater advances and discoveries 
in syphilology will follow, even in our own day. 

We may now briefly mention, as far as possible in chronolog- 
ical order, or in the order in which they have been described, 
some of the endemic occurrences of syphilis as they have been 
determined by later research. Some of the instances reckoned as 
endemic by certain writers have been included in the preceding 
table of Epidemics, more properly, as it is thought, and are there- 
fore omitted here : such are the Mai de Briinn, 1577; Mai de St. 
Euphemie, 1727; Plan de JVerac, 1752, and Mai de Chavanne-Lure, 
1828. 

1. Sibbens (Siewens, Sivvens, 1690). The earliest to be 
observed of these endemic diseases which are now recognized to 
be syphilis is the Sibbens or Siewens of the west of Scotland, 
which was first noted in 1690. The mode of introduction of the 
disease is unknown, but all accounts agree in regard to the fact 
of its being most frequently communicated by eating and drink- 
ing from the same utensils with those affected, from smoking the 
same pipe, also in nursing, and by hereditary transmission. Bell, 1 
who gives the fullest description of it, from personal observation, 
states that it rarely appeared on the genitals, and that it was not 
regarded as a venereal disease. At one time, says he, ' ' The 
disease had spread to such an alarming extent that more than 
three-fourths of the inhabitants were infected and many of the 
more delicate, particularly young children, died under it. This 
had gone on for many years, when by the exertions of the clergy- 
man of the parish, it was entirely removed in the course of a short 
time. He went personally to every individual in his parish and 
convinced them of the propriety of applying for medical assistance 
immediately on the disease breaking out, which they agreed to the 
more readily from their being sensible that all of them had got 
the disease in the most innocent manner." Adams 2 also studied 
Sibbens personally and gives a very thorough resume of the writ- 
ings of others; he concluded that it was not syphilis, or venereal 

1 Bell. A treatise on the gonorrhoea virulenta and lues venerea. 1792. Amer. Edit. Albany, 
1814, p. 268. 

2 Adams. Observations on morbid poisons. London, 1807, p. 181. 



126 SYPHILIS INSONTIUM 

disease, as the lesions were so rarely found on the genital region, 
and gonorrhoea was absent. He quotes from Mr. Hill the most 
perfect description of chancre of the lip, resulting "when the 
infection is communicated by a foul pipe or spoon." 

2. Radesyge (17 10). The earliest notice of this disease, which 
has long prevailed in Norway, is found in a letter of Von See, a 
physician in charge of the sanitary service at Christiansand ; he 
reported to the government that during 1743 and 1744 he had 
treated a large number of patients with Radesyge at Egersund, a 
fishing village on the southwestern coast. In 1758, Honoratus 
Bonnevie was ordered to go to Egersund and Stavanger, 38 miles 
further north, to investigate the disease in question. He found 
that it had begun in the latter town, in 1709 and 17 10, when a 
Russian war- vessel had wintered there, it being brought on shore 
by some Norwegian women who had venereal ulcers and virulent 
sore-throat ; the peasants gave it the name of Radesyge, signifying 
foul disease. About the same time a Danish vessel coming from 
the East Indies brought the same malady to the other port, where 
it was named " Maladie d' Egersund." 

Radesyge spread rapidly through Norway and Sweden, so that 
according to Boeck, 1 several parish priests reported from one to 
two hundred affected in each of the parishes, the disease being 
spread principally by nursing ; one of them says, "The diseased 
infants have been nursed by healthy women, who have thus be- 
come immediately infected; or, women having the disease have 
suckled healthy infants, who, attacked in turn, have infected their 
parents." It was also recognized as communicated through the 
agency of the saliva, as on knives and spoons. 

The great prevalence of the disease may be judged from the 
fact that during the five years preceding 1826, there were no less 
than 16,985 patients with syphilis and radesyge admitted to the 
government hospitals in Sweden; 2 the malady was still found to 
be communicated by other means than sexual intercourse in the 
larger proportion of cases, except in the military hospitals. 

This disease has been the subject of much investigation and 
discussion, and its literature is considerable; in 177 1 a Commis- 
sion from the College of Medicine in Copenhagen, reported that, 
excluding cases of leprosy or spedalskhed, with which it had been 

1 Boeck. Traite de la Radesyge, Christiania, t86o. 

2 Behrend. Syphilidologie. Vol. 2, p. 449. 



ENDEMIC SYPHILIS— A MBOYN A PUSTULE 127 

frequently confounded, true radesyge could always be traced to 
syphilitic infection, as Boeck, Sprakel, 1 and others 2 have since 
shown very conclusively. The symptoms of radesyge as described 
by Boeck and others correspond so closely to those seen in late 
and hereditary syphilis, that they need not be detailed here, and 
the pictures illustrating the disease which have been published by 
Behrend, Rust, Willis, Nolte, and others leave no doubt as 
to the identity of the disease in question with syphilis. Hans 
Munk who had charge of a hospital in Stavanger, in 1799, states 
that under the name radesyge were included: 1. Syphilis inson- 
tium, or sibbens; 2. Spedalskhed or leprosy; and 3. Other malig- 
nant sores. He proposed to reject the name radesyge altogether 
and to employ the term sibbens to represent the secondary and ter- 
tiary phenomena of syphilis, which strictly speaking constitute that 
disease. 

3. Amboyna pustule (Boutons d'Amboine; Pocken amboyneuse, 
1 7 18). In the year 17 18 J. Bontius 3 described an endemic disease 
existing in Amboyna, and other islands in the Malay Archipelago, 
which from our knowledge of similar appearances in other countries, 
is now recognized as undoubted syphilis. It was thought then to 
resemble venereal disease, but this idea was excluded on account 
of its arising and being transmitted quite independently of sexual 
intercourse; it was, however, treated most successfully by the 
remedies employed in venereal disease, principally by mercury. 
Bontius says, " In its symptoms it resembles venereal disease, 
but there is, however, this difference, that the malady may arise 
and be transmitted quite independently of sexual intercourse. In 
this disease there are formed on the face, the arms, the legs, 
eruptions of tophus, that is, tumors, hard and scirrhous at first, 
and afterwards abundant on the entire body, and affecting the 
palms and soles ; if the masses begin to ulcerate a viscid, gummy 
material exudes, which is acid and irritating, and a deep ulcer 
results with hard edges. This horrible and disgusting disease 
resembles the lues venerea except that there are not such great 
pains, and caries of the bones does not so readily occur, except in 
neglected cases." 

The cause of the malady was ascribed to the climate, diet, and 

1 Sprakel. De morbo qui dicitur Radesyge. Hales Saxonum. 1864. 

2 See Lancereaux — A treatise on Syphilis. Sydenham Society Edit., London, 1868, Vol. I., p. 34. 

3 Bontius. Medicina Indorum". cited by Rayer. Traite theoretiqueet pratique des maladies de la 
Peau. Paris, 1835, p. 864. 



128 SYPHILIS INSONTIUM 

other agencies, but no one reading the account of the disease can 
doubt that this was untreated syphilis insontium, a view taken by 
Rayer and other authorities. 

4. Disease of St. Paul's Bay (Mai de la baie de St. Paul; Mai de 

chicot; Mai anglais, 1760). This disease is said to have appeared 
at first on the banks of Lake Huron, in 1760, and to have devel- 
oped among the inhabitants at St. Paul's Bay on the St. Lawrence 
River, in 1780. It spread in a few years over the greater part of 
Canada, and committed great ravages among certain Indian tribes ; 
in 1785 it was known that 5,800 persons were suffering from the 
disease. 

The first symptoms, according to Swediaur, 1 were small, 
aphthous sores on the lips, tongue, and cavity of the mouth, and 
more rarely on the genitals. The secretion from these sores had 
such virulence, that it infected those who ate with the same fork, 
or drank from the same glass, or smoked the same pipe ; it was 
also communicated by the linen, clothing, etc. Fathers trans- 
mitted it to their children, and they to their nurses ; when it once 
entered a family it rarely spared a single individual ; both sexes 
and all ages were equally attacked. The disease was also com- 
municated by coitus. The description given of the progress and 
symptoms of the disease as it affected individuals, corresponds 
closely to our present knowledge of syphilis, and resembles greatly 
the accounts given of the spread of syphilis by the writers of the 
fifteenth century. 

5. Morbus dithmarensis (Marsh Krankheit ; Marsksygdom; Mala- 
die de Ditmarsh, 1785). In Holstein there appeared during the 
latter part of the eighteenth century, an endemic disease which 
had hitherto been unknown there and which slowly made exten- 
sive ravages. According to most of the reports of the Royal Sani- 
tary Commission it appeared to have begun during and after the 
building of the crown prince's embankment, between the years 
1785 and 1787; it was thought to have been imported by the 
foreign laborers who were then employed, probably by the Norwe- 
gians, as the malady resembled the radesyge which was then 
known to prevail in Norway. 

The disease was soon found to be contagious and spread over 
the greater part of Holstein, attacking not only the lower classes, 

1 Swediaur. Traite complet sur les symptoms, etc., des Maladies veneriennes; 4th edit., Paris, 
1801, Vol II.. p. 371. 



ENDEMIC SYPHILIS— FA CALDINA 129 

who lived in the low, marshy lands, and in squalor, but even 
affecting the well-to-do land owners and burghers. Struve, 1 who 
lived in Elmshorn, in Holstein, wrote extensively on the subject, 
and while he recognized the similarity of the malady to what was 
known as venereal disease, endeavored to show that it was a 
different affair, partly because although evidently contagious, it 
was most seldom spread by sexual intercourse. He saw whole 
families infected and recognized that " the disease was spread by 
intimate contact, through the use of the same eating and drinking 
utensils, by towels used in common, also by kissing and pipe- 
smoking. " He also states that the disease appears to be acquired 
by hereditary transmission. The description and course of the 
disease, as he depicts it, leaves no question as to its syphilitic 
nature, modified quite possibly, as in the case of radesyge, scherl- 
jevo, and other of these endemic forms, by scorbutic, malarial, or 
other agencies. 

6. Facaldina (1786). This endemic was first developed in a 
little town of 800 inhabitants on the border of the Tyrol, named 
Facaldo, from which it derived its name, and spread more or less 
rapidly to several neighboring villages. According to Zecchi- 
nelli, 2 who described it, it was believed to have been imported by 
a beggar woman suffering from venereal itch, warts, and ulcers 
of the genitals. Like many of the epidemics early described, this 
included a number of diseases, it being specially associated with 
scabies. Marriages especially contributed to spread the disease, 
which attacked adults and children, manifesting itself by deep 
ulcers of the skin and throat, serpiginous eruptions of the neck 
and shoulders, gummy tumors and osteocopic pains, but rarely 
exostoses. It was cured by a mercurial treatment, and Sigmund 3 
who studied the disease both in Vienna and in the regions where 
it is perpetuated, recognized it as syphilis. Marcolini, 4 writing 
in 1829, regarded it as a variety of the Scherljevo, next to be 
described. 

7. Scherljevo (Malo di Scarlievo; Mai de Fiume, 1790). In the 
year 1800 a medical commission was sent by the Government at 
Fiume to the village at Scherljevo, three miles from the coast of 

1 Struve. Ueber die Aussatzartige Krankheit Holsteins. — Altona, 1820. 

2 Zecchinelli — cited by Lancereaux— A treatise on syphilis. Sydenham edit., London, 1868, 
VoL I., p. 41. 

3 Sigmund — cited by Mauriac — Lemons sur les maladies veneriennes. Paris, 1883, p. 232. 

4 Marcolini — cited by Rayer — Traite tbforetique et pratique des Maladies de la peau. Paris, 18351 
t. iii., p. 862. 

10 



13° SYPHILIS INSONTIUM 

the Adriatic and eight miles east of Fiume, to investigate a new 
contagious disease of unknown character which had appeared 
there. 

Several different accounts are given in regard to its first intro- 
duction, but all agree in referring it substantially to persons 
returning from the Turkish war in 1790; these communicated the 
disease first to those immediately around them, by whom it was 
further spread, not only in that village but also through the neigh- 
boring districts, where it remains more or less to the present day. 

The Scherlievo propagated itself with such rapidity, that Cam- 
bieri, who was one of the Commission, states that out of 39,000 
inhabitants in that district, there were no less than 6,000 affected 
in the highest degree, and almost 8,000 others affected in a milder 
degree. Large hospitals were established for the disease, and 
strict sanitary visitation was made, with a result of arresting its 
progress in a great measure. But, for various reasons the sani- 
tary restrictions became neglected, and again the disease increased. 
Another strict surveillance was then made, when among 131,484 
inhabitants there were found 2,972 cases of undoubted Scherlievo, 
and 1, 194 in whom the disease was suspected. Pernhoffer, 1 who 
was physician to the Scherlievo hospital at Portore, reports that 
14,395 cases had been received in the hospital from its opening in 
18 1 8 to 1859 ; the number of cases of the disease had steadily dimin- 
ished, from about 1,200 yearly at first, to but 107 during the latter 
year. The disease was carefully studied by Dr. Cambieri, 2 who 
was sent by the Government and from whose report the following 
description, as it first appeared, is abridged. 

The disease is described as beginning with pains in the bones^ 
worse at night; the voice becomes harsh, and deglutition difficult, 
the throat, tongue and tonsils are red and covered with aphthous 
patches, which give off a purulent secretion, others ulcerate and 
produce much destruction. A general eruption of pustules, or 
papules, of coppery color occurs, especially on the forehead, scalp, 
back of ears, also on the limbs and body; this eruption may be 
followed by one composed of tubercles, and serpiginous patches, 
covered with indolent crusts with a hard areola, and, later, caries 
of the bones may occur, etc. Mercury was found to be the most 
efficient remedy. 

1 Pernhoffer. Untersuchungen und Erfahrungen iiber Scherlievo. Wien, 1868, p. 8. 

2 Cambieri — Rollet — Traite des maladies veneriennes. Paris, 1866, p. 460. 



ENDEMIC SYPHILIS— MAL DI BRENO 13 1 

The poison was communicated by contact, by the use of uten- 
sils and clothes, and was also supposed to be given by the breath 
and by sleeping with those affected: Michahelles, 1 writing in 1833, 
states that // was not communicated by coitus once in a hundred cases. 
It spared neither age nor sex, but was not observed to be acquired 
the second time. Nurses frequently gave it to infants whom they 
suckled. The disease has been observed and described by many 
writers, among them Sigmund 2 in 1855, and is at the present time 
universally acknowledged to be syphilis, either in an acquired or 
hereditary form, as may be judged from the above original descrip- 
tion. All agree, however, that, as is the case in regard to these com- 
mon or popular names of disease, many other maladies are often 
included under that of Scherljevo, the more common of these being 
leprosy, scabies, lupus, scrofuloderma, and other skin -affections. 

8. Mai di Breno (1790). About the same }^ear in which the 
malady was observed at Scherlievo a very similar endemic broke 
out in the little town of Breno, 3 at the foot of the Rhoetian Alps, 
in Lombardy. According to Michahelles it was brought there by 
a French pirate, but did not spread far beyond the valley in which 
Breno is situated. As the description is very like that just quoted 
of Scherljevo, we need not dwell longer on this affection. 

9. Frenga (18 10). In Servia* there has been known, since the 
year 18 10, an endemic affection by the name of fre?iga, which must 
undoubtedly be classed with those already described. It is con- 
tagious, characterized by multiple ulcerations, rebellious in char- 
acter, seated about the face, nose and buccal cavity, and accom- 
panied by pain in the bones. Sigmund, 5 in 1855, recognized frenga 
as old and untreated syphilis, possibly associated with scrofula : 
mercury and iodide of potassium formed the best treatment for the 
malady. 

to. Spirocolon (Spyrokolon, 1820). Under this name, there 
prevailed a similar disease in Greece which was especially noticed 
between the years 1820 and 1825. This disease, which has since 
been recognized as syphilis, 6 was described as especially charac- 

1 Michahelles. Das Mai di Scarlievo. Niirnberg, 1833, p. 32. 

2 Sigmund. Untersuchungen iiber die Skerljevo seuche, etc. Zeitschrift der K. K. Gesell. d. 
Aerzte. VVein, 1855 — Rollet, 1. c. p. 463. 

8 Oesterr. Medizin-Jahrb. V. Heft, ii p. 21 — Lancereaux loc. cit, vol. I., p. 42. 
4 Gamberini. Manuale della malattie cutanee. Milano, 1871, p, 293. 
6 Sigmund. Zeitschrift der wiener Aerzte 1855, p. 23 — Lancereaux, loc. cit., p. 42. 
6 Nouveau Diet, de Med. et Chirurg., T 34, 1883, p. 626 — See also Lancereaux — Traite hist, et prat. 
de syph., 2 me ed M 1873, P- 3 1 - 



X 



I3 2 SYPHILIS INSONTIUM 

terized by the abundance of ulcerated mucous patcnes about the 
anus; this, Jullien 1 remarks, need not cause surprise, considering 
the number of persons there, of both sexes, who were addicted to 
sodomy. 

ii. Morula (Button Scurvy, 1835). An affection, which has 
prevailed in Ireland for many years under the above name is de- 
scribed by Corrigan 2 as follows : Small papules arise, smooth, 
shiny, and slightly elevated, which become scaly and then enlarge 
until they form suppurating tubercular masses, covered with 
crusts: the mouth is also affected. The disease was contagious 
and was thought to be communicated by the use of clothing or of 
sleeping with those affected. It was universally treated with 
mercury. This disease was considered by Wallace 3 of Dublin 
as identical with Sibbens and Scherlievo, and as undoubtedly 
a syphilis, which had become so modified as to lose its power of 
exciting certain of the phenomena commonly observed. 

12. Mai Kabyle (Lepre Kabyle, 1862). This disease, which is 
frequent in Northern Africa, is thus described by Vincent, 4 who 
was for two years resident physician at the hospital in Dellys, 
on the coast of Algeria. Beginning with nocturnal pains, deep 
ulcerations follow, on the arms, shoulders, back, and face, with 
coryza and destruction of the bones of the nose ; perforations 
of the palate occur, also exostoses of the tibia, etc. ; he expresses 
the opinion that the disease does not differ in any way, except in 
severity, from the Mai Napolitain, which the Italian physicians of 
the 15th Century had described under the name Mai Fran$ais, 
which we now know to have been syphilis, beyond a doubt. 
Other observers agree also as to its syphilitic nature. 

Several writers speak of the great infrequency of primary sores 
among the Arabs of Algiers, and Vincent states that the most fre- 
quent mode of communicating the Mai Kabyle was by the mouth, 
as on glasses and objects used in common; heredity was also rec- 
ognized as a very frequent cause of transmission. Arnold, 5 who 
was associated with Vincent in the hospital at Dellys, regards the 
disease as almost entirely hereditary syphilis, it having been un- 
treated and transmitted for many generations. He states that 

1 Jullien. Traite prat, des maladies veneriennes, Paris, 1886, p. 481. 

2 Corrigan. London Med. and Surg. Journal, July, 1835— Behrend's Syphilidol., Vol. V., p. 450. 

3 Wallace. Ueber die Nature, etc , der Syphilis— Behrend's Syphilidol. I., 475. 

4 Vincent. Expose clinique des mal. des Kabyles, 1862. Rollet. Traite des mal.vener.,p. 450. 
6 Arnold. Dermatologie Africaine; La lepre Kabyle, Paris, 1862, pp. 8, 46. 



ENDEMIC SYPHILIS— SYPHILOID 133 

one-fifth or one-quarter of the patients were children, from those 
at the breast to the limits of adolescence. He, also, found primary 
sores very rare, and the lesions most commonly presented by lepre 
Kabyle were ulcerated gummata, situated mainly on the shoulders 
and extremities. 

13. Yang-mey-tchoang (1863). In China 1 there has been known 
by this name, for an indefinite period, hundreds of years, a disease 
which is very contagious and may be communicated without 
venereal contact ; but it is also recognized as resulting often from 
imperfectly-cured venereal disease. It commences with fever 
and pains in the limbs, followed by an eruption of papules, 
beginning in the groins and extending gradually over the entire 
body. At first small, these lesions increase insensibly in size, 
become covered with scales and blackish crusts, fuse together, and 
make masses which are likened to a raspberry (framboesia) ; in 
each group one tumor larger than the others may be recognized, 
from which flows a serous and fetid material, which forms the 
crusts. Mercury is recommended for the cure, both in the form 
of ointment and also by means of vaporized inhalations. 

Excellent descriptions of chancres are given in the work of 
Dabry referred to, which is simply a translation of Chinese 
writings, ancient and modern, with the statement that in addition 
to the genital region they may also be found in the mouth, throat 
and nose ; but syphilis as a disease does not seem to be understood, 
nor are the mucous patches about the mouth and throat, which are 
very accurately described, recognized as contagious. 

14. Syphiloid (of Courland, 1757, of Jutland, 1777, of Lithuania, 
1780, of Hesse, 1800, of Esthonia, 1805, Kleinrussische Syphiloid, 
1858). 

Under the name of syphiloid, there have existed endemic diseases 
in the regions above mentioned, and others, for many years, and, 
while they have been thought to resemble syphilis in many re- 
spects, they have generally been regarded as in some manner 
different; but in later years their identity with syphilis has been 
established beyond a doubt. Of these Courland, Lithuania, and 
Esthonia are Baltic provinces and adjacent to one another. Bol- 
schwing, 2 who was a parish physician in Courland, describes very 
fully the disease as seen there, under the name "Syphilis modificata-" 

1 Dabry. La medicine chez les Chinois : Paris, 1863, p. 263. 

2 Holschwing. Ueber Syphilis und Aussatz. Dorpat, 1834, p. 10. 



134 SYPHILIS INSONTIUM 

he mentions as the first and principal distinguishing mark between 
this and ordinary syphilis, the fact that "chancre of the genitals 
occurs in such very exceptional cases, that the acquiring of the 
disease by sexual intercourse is a very unusual event." The 
" Kleinrussische or Polish Syphiloid," which has long prevailed in 
the inland provinces of Poltava, Tchernigon, and Kiew, in south 
of Russia, and also in Podalsk and Volhynia, and throughout Po- 
land, has recently been described and portrayed by Hubbenet, 1 
and recognized unquestionably as syphilis, although, presenting 
certain unusual features. He describes the disease as mainly con- 
sisting of mucous papules, whose origin is often unrecognizable, 
at least not attributable to any preceding chancre, and generally 
occurring alone and apparently without any other syphilitic symp- 
toms ; in some villages a large number were affected at once, and 
it was specially frequent among children. 

The Syphiloid of Jutland is perhaps the most interesting of this 
group. In 1777 Dr. Lillie 2 was sent to Denmark to examine the 
disease, and he thought that it was to be distinguished from true 
syphilis by the fact that gonorrhoea was rarely seen among those 
affected. In 1835 Van Deurs, 3 of Aalborgin Denmark, made a care- 
ful study and report of the disease, and, while it was known to be 
communicated by sexual intercourse, he' dwells upon the fact of 
its being constantly acquired by the common use of spoons, drink- 
ing glasses, pipes, etc. ; young and old were infected, although 
young people and children seemed particularly susceptible to the 
disease. His description embraces almost all the well-known 
symptoms of syphilis, and need not be detailed here. He regarded 
the disease as analagous to Sibbens, Radesyge, and other affec- 
tions above described: the name syphilis insontium, however, Avhich 
had been applied by Hans Munk 4 to Radesyge, he does not think 
as suitable an appellation as syphiloid, which, as he expresses it, 
"may not only reproduce itself as a syphiloid, but may, under 
certain conditions, give rise to primary cases of true syphilis, even 
as varioloid can occasion true smallpox." 

15. Framboesia (Yaws, Pian). After a study of the disease-con- 
ditions thus far spoken of in this chapter, it is not very difficult to 
discern in all the descriptions of Yaws, given by different writers, 

1 Hubbenet, Die Beobacht. und das Exper. in der Syphilis. Liepzig, 1859, p. 80. 

2 Lillie— Cited by Rollet. Traite des Maladies veneriennes. Paris, 1866, p. 475. 

3 Van Deurs. Jour, for Med. og Chirurg.,1835. Behrend's Syphilidol.,Vol. V., 1844, p. 432. 

4 Hans Munk— Cited by Rollet. Traite des maladies veneriennes. Paris. 1866, p. 473. 



ENDEMIC SYPHILIS— FRAMBOESIA 135 

data which point, almost incontestibly, to the fact that this affec- 
tion is connected with or dependent upon the syphilitic poison. 
The subject is a large one, and the literature relating to it is 
extensive, and a full consideration of the disease and the opinions 
• respecting it would lead beyond the scope of the present work ; it 
must be stated, however, that while the French, and most of the 
German writers, regard it as undoubtedly syphilitic, many others, 
and among them some who have observed the disease personally, 
hold that it is an affection sui generis and different entirely from 
spyhilis. Pontoppidan, 1 of Copenhagen, who has made one of 
the most recent personal studies of the disease, holds that it is 
non-syphilitic, and gives the following condensed description of 
the disease; which, however, is certainly suggestive of syphilis 
and of the eruptions previously described : 

' ' Yaws is a contagious disease of the skin which appears 
without any essential disturbance of the general health, in the 
form of small papules appearing beneath the epidermis; when 
they reach the size of peas they become covered with an epidermal 
mass, and the round, elevated, nummular tumors acquire a thick, 
pulpy, adherent, yellowish crust much resembling a dirty ivory 
counter, or a smooth, round, cheesy button. When this crust is 
removed a moist, reddened but not ulcerated, elevated surface is 
seen, appearing like a mucous papule, and when it is much ele- 
vated and exuberant, or treated with irritating applications, it has a 
distinct resemblance to a raspberry. When the tumors are in the 
ano-genital region, they may resemble mucous patches of severe 
degree ; but on places more or less exposed to the air, where they 
are principally situated, as on the face and extremities, they have 
always the dirty-yellow, smooth crust." 

Yaws have been communicated by experimental inoculation, 
and when so induced, the wound inflames, and is thereafter cov- 
ered with a brownish scab, beneath which there is a small sore 
depressed in the centre, with raised edges, giving out ichor. 2 
Charlouis, 3 a Dutch physician in the island of Java, has also 
made a recent study of framboesia there and believes it to be a 
separate disease distinct from syphilis; he had seen recent syphilis 
develop from a chancre in two cases (one of them experimentally 

1 Pontoppidan. Archiv fiir Dermatol, und Syph., 1882, p. 201. 

2 Christie. — M'Call Anderson's Treatise on Diseases of the Skin. London, 1837, p. 395. 

3 Charlouis — Vierteljahresschrift fur Dermatol, und Syphilis, i38i, p. 431. 



136 SYPHILIS INSONTIUM 

inoculated), which presented lesions of a characteristic framboesia, 
previously existing. 

More research is required to determine the matter with cer- 
tainty, for from the description given of the malady by different 
observers, it is probable that several disease-conditions have at 
times been included under the designations framboesia, yaws, 
and pian; and one cannot help the conviction that many of the 
cases so named have been syphilis, modified, perhaps, as in other 
instances, by race, climate, etc. 

16. Aleppo evil, Biskra bouton, Chancre du Sahara, Caneotica, 
Delhi Sore, Scinde boil, Parangi. Under these and other names 
there are known in the various countries of the East, as Syria, 
Northern Africa, Crete, India, and Ceylon, a disease or diseases, 
manifesting mainly cutaneous lesions, chronic in character, slowly 
ulcerating, and corresponding more or less perfectly to the well- 
known appearance presented by late syphilis. The pictures given 
by Willemin, 1 of the Aleppo Evil, and by Vandyke Carter * of the 
Biskra Bouton, Caneotica, and Aleppo Evil, are certainly so 
strongly suggestive of late syphilis that it is difficult to believe 
that they are other than this protean disease, modified, as we have 
seen, in the above descriptions, by race, climate, etc. Geber, 3 
after spending some time in Aleppo, and studying clinically a con- 
siderable number of patients with the ' so-called Aleppo Boil or 
Evil, came to the conclusion that no such special endemic disease 
existed, but that the cases thus called were lupus, or the mani- 
festations of syphilis, or scrofula, both of which were very frequent, 
modified by peculiarities in race, climate, etc. All researches go 
to show that syphilis is very prevalent in the localities named, as 
also in other parts of the world. 

The above-mentioned endemic manifestations of syphilis by no 
means represent all of the instances where the disease has spread 
widely among a people or community ; they are given rather as 
the best described examples of how syphilis may be introduced 
and gain a great footing long before its true nature is known. In 
the endemics here referred to a local name early became attached 
to the malady, which was not recognized to be syphilitic until 
at a later period; and of this, other similar instances could be 

1 Willemin. Memoire sur le Bouton d'Alep. Paris, 1854 

2 Vandyke Carter. On certain endemic skin and other diseases of India. London, 1876, p. 64. 

3 Geber. Vierteljahr. fur Dermatol, und Syphilis, 1875, p. 445. 



ENDEMIC SYPHILIS— ALEPPO EVIL 137 

adduced, such as the Boala of Roumania, Maladie de Berreshof 
and Lepra Siberica in Siberia, Tonga in New Zealand, etc., etc. 
Syphilis is also widely recognized in many countries under its 
own proper name, or under equivalent designations, but in many, 
if not in most localities the date and method of its introduction 
and dissemination have not been specially recorded, if indeed they 
are at all known. 

In looking over the accounts given of the disease, both those 
represented by the above abstracts, and the descriptions of syph- 
ilis as it has been observed in other lands, one is struck by the 
diversity of conditions under which it has spread and the variety 
of forms under which it has been observed ; it is, therefore, only 
by the synthetic study of the disease, as occurring in different 
countries, with diverse influences of race, climate, food, and other 
circumstances, that a true and full knowledge of its course and 
manifestations can be obtained. Thus, in many places we find 
writers very positive that the primary sores were not often pre- 
sented to their observation, and in very many localities the disease 
was known to be propagated almost wholly by non-venereal means. 
In some regions it has been observed to expend much of its viru- 
lence in the mouth and throat, especially in the colder climates 
of Scotland, Norway, and Canada, as observed in the Sibbens, 
Radesyge, and Disease of St. Paul's Bay; while in warmer regions 
the skin suffers most from its ravages, as in the Scherlievo, Mai de 
Kabyle, and Amboyna pustule, seen in Dalmatia, Northern Africa, 
and the Molucca Islands respectively. 

In all of these epidemic and endemic developments of syphilis, 
a certain similarity can be discerned, and a more or less definite 
course has repeatedly been observed ; it will be noted that many 
of those recording them report a certain resemblance of the 
particular outbreak to some other previous endemic affection 
occurring elsewhere, such as the Sibbens, Scherlievo, Framboesia, 
etc., and many writers compare the phenomena observed, to those 
reported in connection with the celebrated outbreak of syphilis at 
the close of the 15th century. As, in the epidemic in the 15th 
century, the disease became mitigated in severity, so that it did 
not retain the pestilential character for more than seven years, 1 so 
in the case of most of the subsequent epidemics and endemics, 

1 Lancereaux. A treatise on syphilis. London, Sydenham Soc. Edit. 1868, p. 27. 



138 SYPHILIS INSONTIUM 

the malady seemed to die out gradually, as far as concerned its 
immediate and very frequent propagation ; but, on the other hand, 
syphilis remained in a relatively mild and non-pestilential form, in 
many of the countries mentioned, and may still be observed in 
them, as indeed it now exists over a large portion of the globe. 

The reason for this diminution in severity, in its epidemic and 
endemic forms, is readily understood in the light of our present 
knowledge of syphilis; the disease reaches, in a certain sense, a 
self-limitation, dependent on facts such as the following : 

1. All are not equally susceptible to the syphilitic virus, and 
some persons, probably, never can be infected; 2. Many persons 
are never exposed to the disease, as it is communicated only by 
direct or indirect contact with the virus; 3. With rare exceptions, 
•the disease can be acquired but once, and 4. The influence of 
heredity from syphilitic parents greatly limits the susceptibility 
to infection, and, it is believed, modifies the disease when acquired. 
Thus it can be seen readily, that in a virgin soil the disease might 
make great progress in a short time, and then, in a large measure, 
cease, owing to the infection of most of those directly exposed to 
it ; it being further propagated only as chance shall bring it fresh 
victims, or as circumstances shall bring the poison to those who 
had previously escaped. 

That the danger of such sudden extensions of syphilis by inno- 
cent means extends even to our own time, may be learned at a 
glance from the table of epidemics of the disease given in the first 
part of this chapter, where it is seen that certain of these have 
occurred even very recently. As a single example may be men- 
tioned an epidemic which occurred in the village of Capistrello, 
not far from Naples, Italy, as late as 1857. 1 The disease had 
existed in the community unrecognized for eight years, and had 
consequently been untreated, and, when it was investigated by 
the sanitary officers, it was found that among a population of three 
thousand persons, no less than three hundred individuals, men, 
women, infants, and old men, had been infected. The epidemic 
had started from a single infant brought to the town with heredi- 
tary syphilis, who communicated it to its wet-nurse, and then to 
others who had relations with them, mainly through the agency 
of household utensils ; no mention is made of any communication 
of the disease through illicit intercourse. 

1 Annales de dermatologie et de Syphiligraphie, 1867, p. 158. 



ENDEMIC SYPHILIS 139 

In many of the accounts of epidemic and endemic syphilis we 
find descriptions mainly of the later tubercular and ulcerative 
lesions, and in some regions it is claimed that these are the only 
ones observed, no mention being made of the earlier phases, the 
macular, papular, and pustular eruptions, with which all are 
now familiar as commonly recognized in the disease. This may 
be explained satisfactorily on several grounds, such as the follow- 
ing: 1st, The earlier eruptions may have escaped the attention of 
the patient, and not have been presented to the physician, as' is 
often the case at the present time; 2nd, The connection between 
the primary sore, the earlier eruptions, and the later manifesta- 
tions of syphilis were not then generally known and recognized ; 
3d, It is quite possible that, for reasons unknown to us, the earlier 
expressions of the disease were much lighter in olden times or 
under special conditions, than they are apt to be now ; 4th, Patients 
naturally applied for the relief of the more severe, chronic, and 
destructive lesions, leaving the earlier and more or less self -limited 
eruptions to their own course; and, 5th, Much of the disease, after 
a certain period, was acquired by heredity, and, being untreated, 
later, destructive lesions would result and call for treatment ; it is 
to be remembered that the connection with, and significance of, 
the earlier manifestations of hereditary syphilis was not recognized 
or known until at a comparatively recent date. 

The statements with regard to the absence of gonorrhoea and 
extensive genital lesions are, of course, perfectly understood, now 
that gonorrhoea and chancroid are recognized as entirely distinct 
diseases from constitutional syphilis. 

An interesting point in this study is that in regard to the later 
effects of the syphilitic poison, both on the individual and in later 
generations, when the disease is left wholly uninfluenced by treat- 
ment; this we know to have been largely the case in many of the 
epidemics and endemics in earlier times, where it spread gradually, 
unrecognized, in different quarters of the globe. We have no 
means of solving the problem, as to how far this accounts for the , 
appearances presented by syphilis in the descriptions quoted, but the 
question naturally arises whether the peculiarities presented by 
the supposed different diseases above mentioned in different coun- 
tries, may not be thus accounted for. The same is true in regard 
to some of the eruptions still observed among the older nations, 
such as Framboesia, Delhi boil, Aleppo evil, Bouton de Biskra, etc., and 



140 SYPHILIS INSONTIUM 

the question is quite proper whether their peculiar features may 
not be owing to the implantation of syphilis in persons who had 
already had the disease by inheritance or otherwise, in earlier 
years, or who still were under a remote influence of the same, 
transmitted through former generations: Jonathan Hutchinson 1 
has recorded cases where the disease was acquired by those who had 
already suffered from hereditary syphilis, and in two of these 
instances, the lesions of the acquired disease, presented unusual 
features, in having ecthymatous ulcers within a few months after 
the primary sore ; others 2 have also remarked upon the modified 
results of syphilitic infection which may be observed in those who 
have inherited the disease or have suffered from it previously. It 
is now, also, a well-established fact that syphilis may be trans- 
mitted to the third generation, what its later effects are we do not 
know ; much that is often called scrofula is afterwards shown to be 
only late and indefinite manifestations of syphilis. 

It would lead quite beyond the scope of the present work to 
fully discuss here many of the interesting points which might 
follow from a consideration of the data already given, and on 
record elsewhere, in regard to the epidemic and endemic spread 
of syphilis, some of which will be briefly considered later, in con- 
nection with other portions of our subject; a few words, however, 
may be added here in regard to the modes in which the disease 
has been spread in a general manner, the special methods of its 
extension being considered in subsequent chapters. 

It is difficult for us, amid the civilization of the nineteenth 
century, to fully understand the circumstances and surroundings 
which led to the rapid and extensive diffusion of syphilis in years 
gone by, and amid the crude modes of living belonging to earlier 
times ; but we can better understand it if we consider, for a 
moment, some facts relating to its more recent extension among 
some of the less civilized portions of the earth, as in certain parts 
of Russia, and elsewhere, where syphilis is certainly largely on 
the increase. Hjelt 3 reports that in Finnland, where all venereal 
diseases are treated in the governmental hospitals, free of expense, 
and where a very large share of all cases of syphilis are thus col- 
lected, the cases of this disease had increased from 2,511 in 1851, 

1 Hutchinson. Syphilis-- London, 1887, p. 387, 392. 

* Lectures on syphilitic and vaccino-syphilitic inoculations, etc., by Henry Lee, London, 1863, 
p. 215. 

3 Hjelt. Die Verbreitung der vener. Krankheiten in Finnland. Berlin, 1874, p. 70. 



ENDEMIC SYPHILIS 14 1 

to 8,629 in 1870; the total number of syphilitics treated during 
that period was 54,717 cases. The total population in 1870 was 
1,773,612, and the number of cases treated during that year, 
namely, 8,629, was at tne rate °^ one ^ or ever y 2 °4 persons. 
Presumably a large proportion of these cases were recently in- 
fected. In other portions of Russia, according to Leinenberg, 1 
the disease has made and is still making yet greater ravages, so 
that one writer states that there are at present five millions of 
syphilitics in Russia ; in the cities it is spread largely by prostitu- 
tion, with the attendant innocent inoculations, but outside of the 
cities it occurs by innocent methods, largely by family and indus- 
trial intercourse, as it is stated that the peasantry know no prosti- 
tution. Blosfeld, 2 writing of the spread of syphilis in Kasan, 
in Eastern Russia, speaks of its very common spread by means of 
extra-genital infection. 

The principal cause of the continual spread of syphilis, in this 
and other countries, lies in the ignorance of the people: 1st, As to 
the real nature of the disease; 2d, As to the dangers of infection, 
innocently or otherwise ; 3d, As to the modes by which infection 
may take place, and 4th, As to the means and measures necessary 
for prevention. 

It is, of course, not to be expected that the mass of persons 
will ever be able to recognize syphilis in all of its phases, 
or to know of and exercise the proper prophylactic measures 
necessary to avoid contagion ; but in proportion as it is recognized 
that it is not uncommon for syphilis to attack those who are 
entirely innocent of sexual transgressions, by so much will the 
danger of the extension of syphilis insontium be diminished. 

That these cases of the innocent inoculation of syphilis are still 
not very infrequent, at the present time, is evident from the fact 
that the present writer has observed in his own practice, and re- 
corded in a preceding chapter, over a hundred instances of the 
same, in addition to the mass of other illustrations here set forth. 

We will now consider more particularly the various modes and 
occasions by which the disease has been spread sporadically, as 
recorded in the literature of the subject. 

1 Leinenberg. Die Syphilis in Russland. Miinchen, 1887. 

2 Blosfeld. Zeitschr. fur Hyg. med. Statis. u. Sanitiitspolizei, 1869, p. 442. 



CHAPTER VII. 

B. SYPHILIS SPORADICA 1. SYPHILIS ECONOMICA ; INCLUDING, 

I. SYPHILIS ACQUIRED IN DOMESTIC AND SOCIAL 

RELATIONS AND, 2. SYPHILIS COMMUNICATED 

IN INDUSTRIAL RELATIONS. 

Having considered syphilis as a pandemic affection, occurring 
at times as i, An Epidemic, affecting considerable numbers in a 
short space of time, and 2, As it has existed in an endemic 
manner, slowly attacking larger communities, we may now turn to 
a consideration of the methods and means by which it is commu- 
nicated to individuals in a thoroughly innocent manner. 

To this the designation syphilis sporadica has been given, to 
indicate the individual character of the infection. 

By reference to the classification of the modes of infection of 
syphilis, already given, it will be seen that this part of the subject 
is subdivided into three parts, relating to, 

I. Syphilis Economica, where the infection occurs in domestic 
or social life, and in industrial relations ; 

II. Syphilis Brephotrophica, where the disease is communicated 
in connection with the nourishment and care of children ; and, 

III. Syphilis Tech?iica, where inoculation takes place in the 
discharge of professional duties and body service. 

These will be considered in turn in this and the two following 
chapters. 

I. SYPHILIS ECONOMICA. 

The sporadic transmission of syphilis econo?nica may be studied 
as relates to, 

1. Infection occurring in connection with domestic or social 
life, and, 

2. Infection resulting from industrial relations. 



INFECTION BY EATING AND DRINKING 1 43 

In each of these two groups we will find a number of divisions 
and subdivisions, while the ultimate sections into which this class 
of infections may be divided is over forty, as shown in the classi- 
fication which has preceded (pages 17 to 20); the data and refer- 
ences to the Bibliography relating to these will be found expanded 
fully in the Synopsis of Literature. 

It will be seen that a very large share of these infections occur 
through the agency of the mucous membrane of the mouth, a few 
happen through sores on the fingers, and occasionally the disease 
will be conveyed by means of substances soiled by blood and se- 
cretions from various parts. We may now call attention briefly 
to some of the principal features relating to the modes of trans- 
mission in syphilis economica. 

1. Infection in Domestic and Social Relations. 

This great group may be divided again according as infection 
takes place through, 

1. Eating and drinking utensils, and the use of tobacco, etc. ; 

2. By personal and household effects; 

3. By active and temporary contact; and, 

4. By passive contact. 

I. Infection by eating and drinking utensils, and in the use of 
tobacco, etc. The two divisions of this section will be considered 
separately. 

1. Infection by implements and utensils (spoons, knives, forks, cups, 
glasses, jugs, etc.). In very many of the accounts of epidemics 
of syphilis referred to in the preceding section, and also in the de- 
scriptions of the endemic forms of the malady, such as Sibbens, 
Radesyge, and the syphiloid eruptions, constant mention is made 
of the disease being communicated in eating and drinking; and 
more modern writers in some of the countries of Europe confirm 
these descriptions, even to this day, among the peasantry and the 
poorer classes in large cities. As these wholesale dangers can 
hardly be fully understood by those accustomed to the luxuries of 
wealth and western civilization, I may briefly quote the descrip- 
tion given by Boeck, 15 of the manner in which infection still takes 
place in Norway. Says he, " In the country districts, it frequently 
happens that syphilis is communicated by the use of the same 

15 These and following reference numbers refer to the consecutive numbers of separate books or 
journal articles under each author's name in the Analytical Bibliography: where no number is given 
the reference is to the single article or book mentioned. 



144 SYPHILIS INSONTIUM 

spoon. In many places the members of the family do not eat 
together at the same time, and as each comes in turn to the table, 
a single spoon is used, which is not washed, but is licked off and 
laid aside. The spoon is a broad, rough, wooden affair, which is 
thrust so far into the mouth that the angles of the lips are 
stretched, and may even be injured by it. The fact is certain, 
that in many of the cases of innocently-acquired syphilis, the ulcer- 
ations commonly come in the corners of the mouth." 

Instances of infection by eating utensils are reported by several 
recent observers ; Rollet 7 gives the case of a lady, who contracted 
a chancre of the lip, from carrying in the mouth a spoon used by 
her cook; and Diemer 6 mentions one, where the contagion was 
acquired by the use of the same knife and fork on shipboard; 
RoussEL 2a relates the case of a child, seven years old, who contracted 
a chancre of the right tonsil, by using a spoon after its mother, 
and Krowczynski 1 gives a similar instance ; Lee 6 reports the case 
of a young female, seen with chancre of the tongue, acquired from 
a spoon used by another servant, who had syphilitic lesions in the 
mouth ; the genitals were intact. Other cases could be cited, and 
many writers casually mention having observed the same. Cups 
and drinking vessels are frequently reported as conveying the 
poison, the first recorded case being the well-known one given by 
Botallus in 1563, where a chancre of the lip' was acquired from 
drinking after one infected; Buchholz repeated the observation 
in 1798, the patient acquiring the disease from a tankard in a beer- 
house, since which time dozens of similar cases have been placed 
on record, as seen in the Synopsis of Literature. 

The so-called Maladie de Chavanne-Lure, belongs to this class 
of syphilitic transmission, and may be briefly mentioned. In the 
year 1829, M. Flamande reported that in the community of 
Chavanne-Lure, on the east border of France, there had existed a 
malady for about twenty-eight months, which was considered 
contagious, and that up to that time, about twenty-five persons 
were known to be affected, although it was supposed there were 
many more also diseased, who from false modesty concealed their 
trouble ; the description given is readily recognized to be that of 
syphilis. The first person to be affected was a man named Goudy, 
28 years of age, who at that time had had the disease for over two 
years, with mouth and throat lesions as well as eruptions on the 
skin. He first communicated it to his three young children, all 



INFECTION BY EATING AND DRINKING 145 

of whom had sores on their lips and throat, but his wife, although 
living with him, escaped, and was the only individual in the 
family who was not infected. A young girl, a relative, aged 14, 
next acquired the disease, from frequently eating with these chil- 
dren, and her brother became similarly affected a short time 
after ; their mother next acquired the disease from frequently 
visiting the house, and eating with the children first affected, and 
six months later she gave it to her husband. It is added that the 
people of the town were convinced, that the malady was especially 
propagated by means of eating utensils, which, it is remarked, is 
the more probable, because the inhabitants of the country eat one 
after the other, without the least precaution in cleansing the 
utensils. The man Goudy, who first brought the syphilis to the 
town, acquired it while a prisoner, from drinking from the same 
vessel with an Austrian soldier, who had the same disease on the 
lips. The beginning of this epidemic, put in tabular form, 
appears as follows : 

P. F. G. 

communicates the disease 
to 

his young child his young child his young child 

I ! ! 

They communicate the disease 
to 

I i I 

girl cousin boy cousin aunt 

(14 years old) (15 years old) who infects 

husband 
T. B. G. 

One of the most definite and satisfactory of the single cases is 
that of Sigmund, 16 where a gentleman was infected by his valet, as 
they traveled through the country ; C. Pellizzari 11 also reports the 
case of a workman, who shared his lunch and a common drinking 
glass with a comrade, who had syphilitic placques on the lips. He 
had a fissure on the lip, and this became the seat of a chancre. 
Taylor 12 mentions the case of a female cigar-maker, who had an 
immense chancre of the lower lip, contracted from a drinking-cup 
in use in the factory. 

Some time ago much interest was excited by Gruner 1 in 

1 Gruner, Chr. Gottfried. Der Gemeinschaftliche Kelch, etc. Jena, 1785. 
11 



146 SYPHILIS INSONTIUM 

regard to the danger of the communication of syphilis by the 
chalice, or communion cup : although this means of infection is 
quite possible, I have not been able to find a single case in 
literature, th^ original writings of Gruner, Trall, and Metzger 
not being accessible. 

2. Ififectioii by tobacco-pipes, cigars, troches, etc. The earlier 
accounts of the epidemic and endemic manifestations of syphilis, 
as they are now known to be, contain frequent statements, that 
the disease was also constantly transmitted by a pipe, which in 
earlier times frequently did duty for many smokers, or a whole 
household. Denis-Dumont 1 mentions a case, where an officer 
was infected, under his own observation, in a hospital, from 
smoking the pipe of one of his colleagues who had placques mu- 
queuses; Guignard 3 reports a case from the service of Fournier, 
where a chancre of the tongue resulted from the use of a friend's 
pipe; Boeck" speaks of a case of chancre of the tongue resulting 
from the repeated smoking of the pipe of a friend, with constitu- 
tional syphilis; Otis 4 mentions the case of a physician with a chan- 
cre just within the right inner angle of the mouth, contracted from 
a pipe belonging to a syphilitic friend; C. Pellizzari 15 records an 
instance, where syphilis was acquired from a pipe, borrowed for 
the occasion, to hold in the mouth while sitting for a picture. 

Cigars may be the means of conveying the syphilitic virus, the 
poison being conveyed to the cigars either: 1st, during their man- 
ufacture, or, 2nd, by a subsequent infection. Kluge claimed, 
nearly fifty years ago, that he had known syphilis to be communi- 
cated by means of cigars, infected by the fingers in the process of 
manufacture. In the two cases of physicians reported in Chapter 
IV. (Cases XXXV. and XLIV. ), chancre of the lip was probably 
acquired from cigars, which had been infected in their manu- 
facture, presumably by the act of finishing the cigars with the 
lips ; this supposition was supported by a case, there referred to, 
as having been just seen and treated, where a cigar-operative was 
obliged to desist from this practice, on account of the soreness of 
the mucous patches on the lips, on which he had been moistening 
his cigars. A further possible means of infection is found in the 
alleged practice in Havana, of finishing the cigar by rolling it on 
the naked thigh, many of the natives in Cuba having syphilis. It 
is but just to remark, that Sigmund, 1 at the direction of the 

1 Sigmund. Wiener med. Wochenschrift, 1S62, No. 4. 



INFECTION BY WEARING APPAREL 1 47 

Government, investigated certain cases of alleged infection of 
cigars in manufactories, and expressed his disbelief in the truth 
of the reports. 

The second method of communicating syphilis by cigars, relates 
to their infection by others than those engaged in their manufac- 
ture. Gamberini 2 reports an interesting case, where a man re- 
ceived a chancre of the upper lip from a cigar, taken from the 
mouth of a woman, who had syphilitic lesions of the fauces. F. J. 
Behrend 4 alleges, that he treated a patient with syphilis, who 
acquired the sore in the mouth from taking a cigar, which had 
been placed in the mouth of another person, and bitten off. 
Rizat 1 reports a case, where a man acquired a chancre of the lip, 
after having cut the end off a cigar in a guillotine, which had just 
been used by a friend, who had moistened his cigar on the lips, 
before cutting it in the same machine. The most common method 
by which syphilis has been acquired by cigars, however, is that 
seen in smoking rejected cigar-stumps, cases of which have been 
reported or mentioned by a number of observers, Ambrosoli, 
Englested, Finger, Drysdale, and others. The report of Ambro- 
soli, 1 is most complete and relates to two cases. Engelsted 2 
states that he had treated a little boy, who was infected by a cigar- 
stump which his uncle, who had mucous patches of the lips, had 
thrown away. 

Akin to this method of transmission is that reported by Hardy, 
and also by Leloir, 13 where the infection occurred by means of a 
pastille, passed from mouth to mouth ; since which similar cases 
have been reported by £-riffin, Neumann, Taylor, and others. 

2. Infection by personal and household effects. This relates to 
1. Wearing apparel; 2. Bedding; 3. Toilet articles ; 4. Miscellane- 
ous articles. 

1. Infection by wearing apparel (underwear, bathing-suits, masks, 
plasters, bandages, lint, etc). 

Numbers of cases have been reported by various observers, 
where articles of clothing have communicated the disease, none 
of them more striking than the original observation detailed in 
Chapter IV. (Case CXIII.); in this instance a gentleman acquired 
a chancre in the sacral region from a public bathing suit, he 
having had for some time an eczematous fissure in the fold of the 
buttocks, and scratching it through his garment. Jullien 4 quotes 
Diday, as having seen two cases of chancre of the anus, thus 



L 48 SYPHILIS INSONTIUM 

communicated by clothing. Acton, Bell, Bondet, and others 
have also recorded cases. 

Leloir 10 records a case where the virus was transferred on 
the finger of a glove, causing a chancre of the eye, and quotes 
Ricord as authority for the conveyance of syphilis by a mask. 
Henning 1 reports the disease communicated by means of a hat, 
and Polaillon a case where syphilis was acquired, apparently, 
from the injury caused by a nail in a borrowed shoe, giving rise 
to a phagedenic chancre of the foot. 

Eandages, lint, etc., have been the means of conveying syphilis; 
thus Bjorken x mentions the case of an adult who threw away 
a piece of emplastrum hydrargyri, which had covered a syphilitic 
lesion, and his little brother, on applying it to a wound on the back of 
the hand, was infected ; a somewhat similar personal instance is 
related in Chapter IV. (Case CXI.) where the chancre appeared on 
the neck after the application of a piece of plaster to a scratch, the 
plaster being wet on the tongue of a friend. Ricordi 2 narrates 
the case of a woman who acquired a chancre on the breast, from 
the application to it of some dressings which had been used on a 
chancre of the nipple of a friend. 

2. Infection by bedding (pillows, sheets, etc.). While it is more 
than probable that pillows, sheets, etc., have frequently conveyed 
syphilis, relatively few cases have been reported. It is most 
natural that secretions from lesions in the mouth, and elsewhere, 
should saturate bedclothing, and, during the prolonged contact of 
sleep, the virus could easily enter abraided surfaces. Jullien, 
Popoff, Salsotto, Taylor, and others, have reported cases of this 
nature. 

3. Infection by toilet articles (towels, sponges, combs, tooth- 
brushes, syringes, sick-chairs, privy-seats, etc.). A variety of 
modes of infection is found in this group, relating to very different 
portions of the body, and diverse methods of transmission. Baum 6 
records a case where a patient acquired a chancre in the corner of 
the eye, supposed to be due to infection from a towel, used in com- 
mon with a man who had a chancre, and several writers allude to 
similar cases. C. Pellizzari 22 mentions a case where a son, with 
chancre and abundant mucous patches, infected his father while 
on a journey, occupying the same room and using the same towel ; 
the father had two chancres of the face, one in the centre of the 
cheek, the other towards the ear. The same writer reports a case 



INFECTION BY TOIIET ARTICIES 149 

in the clinic of Pietro Pellizzari, where a comb was the means of 
transferring the syphilitic poison to a young- child, producing a 
chancre of the hairy scalp ; the comb had just been used on another 
child, with a pustular syphilide of the scalp ; others have also 
reported cases where the same mode of infection seemed probable. 
Sigmuxd 7 relates the case of a young girl, of good character, who 
acquired a chancre of the vulva, from a sponge used by a work- 
ing girl room-mate, who had mucous placques in the genital 
region. 

Infection by means of a toothbrush, was reported many years 
ago by Blumexbach ; the case was that of a chamber-maid, who 
acquired a chancre in the mouth from using a toothbrush of an 
employer. The same method of transmission has been observed 
by Baxter, Taylor, and Haslund. 1 Mackey reports a case 
where it was claimed that the poison was conveyed by a tooth- 
pick. 

Syringes have conveyed the poison of syphilis, as in the cases 
reported by Fourxier, 9 Julliex, 2 and Leloir, 12 some of which 
occurred while the patients were in the hospital. 

Public urinals, and waterclosets, as well as commodes and sick- 
chairs, are commonly accredited with being instrumental in com- 
municating syphilis, but it is not a little singular, that but very few 
authentic instances of this kind have ever been recorded. Several 
writers refer to this method of acquiring the disease, and accept 
the fact as probable, but we find but six who have reported cases 
illustrative of this mode of infection; Fallopius and Hunter as 
quoted by Ricord, 1 and the case mentioned by Loder x are so old, 
and so briefly mentioned, as to be of little scientific value ; more 
recent cases have been reported by Fitzgibbons, Marc, Roddick 
and Taylor. 

3. Infectio?i by miscellaneous articles of convenience (handkerchief, 
pins, opera-glass, cane). Many articles in common use could be, 
and undoubtedly have been, carriers of the syphilitic virus, but the 
instances on record are but few; the following serve as examples: 
Leloir 11 mentions having seen a chancre at the commissure of 
the mouth, in a man, produced by cleansing the part with a hand- 
kerchief moistened with saliva, and states that Dr. Baudry has 
seen several chancres of the eye, produced in like manner; Fal- 
cone reports a chancre of the right inner canthus, acquired by 

1 Ricord — Lecons sur le chancre. Paris, 1858, p. 26. 



150 SYPHILIS INSONTIUM 

means of an opera-glass ; Otis 2 mentions a tane, as the medium of 
contagion. 

In the original case No. LXXXIX., Chapter IV., a chancre of 
the tongue was probably due to pins which the patient had been in 
the habit of picking up and placing in the mouth, just where the 
sore came on the tongue ; from the frequent habit of picking the 
teeth with a pin it is more than probable that this article may some 
times afford a means of transmitting the virus of syphilis. Koch 
has reported the case of a chancre of the finger in the site of a 
wound made by a sharp drawing instrument, which had probably 
been infected by the saliva of some previous user of the instru- 
ment. 

3. Infection by active and temporary contact. The cases 
occurring here may be divided into two classes, as the infection 
relates to the mouth or finger : 1. Buccal; 2. Digital. 

1. Infection by buccal contact. This may again be divided into 
that acquired, 1. by Kissing, and 2. by Biting. 

1. Infection by kissing. Next to the venereal act, kissing fur- 
nishes, probably, the most common and uniformly frequent mode 
of communicating syphilis, in all countries and under all condi- 
tions, and the number of cases to be found in literature, attributed 
to this cause, is really very large ; the number of instances of this 
kind on record would undoubtedly be very many times greater were 
it not that this method of communicating the disease has so long 
been perfectly established, that cases are not reported, unless they 
present some curious or unusual feature. It may be safely said, 
that where one may be found reported, hundreds have occurred. 

We find two classes of cases; 1st, Those which are here termed 
reciprocal, where the syphilis is conveyed from the lip of one person 
to that of another, and, 2nd, The non-reciprocal, where the lip of 
one person communicates the poison to, or receives it from, some 
other part, as the eyelid, cheek, nipple, etc. The cases illustra- 
tive of these conditions are found so abundantly in literature, that 
it is hardly worth quoting any at length ; few cases, however, are 
more striking than the original one found in Chapter IV. , where 
a widow (Mrs. Z. Z. Case XXVI.) acquired a chancre of the lip 
from another patient (Mrs. V. B. Case CVI.) who was then under 
treatment with abundant mucous patches of the mouth, as a re- 
sult of syphilis from chancre of the hand. The first patient had 

1 Otis. Journal of cutan. and Vener. Dis. New York, 1S86, p. 103. 



INFECTION BY KISSING AND BITING 151 

recently lost her husband, and in her grief had much intercourse 
with the second lady, who was of her own age, and naturally they 
kissed each other frequently; as a result, after being thus exposed, 
a chancre of the lip developed, about one month after her hus- 
band's death. 

As a striking instance of the communication from the lips to 
other parts, may be mentioned a case referred to by Taylor, 10 
where he had prohibited a man who had contracted syphilis, from 
having connection with his wife. He obeyed the instructions, but, 
thinking it safe to suck her nipple, he gave her a chancre in that 
situation. De Beck quotes many cases where chancre was acquired 
about the eye, by means of kissing. 

2. Infection by biting. This may be considered, 
1 st. As it relates to a caress, as has repeatedly occurred in 
connection with the venereal act; 

2nd. As it is used in defense or assault, and 
3rd. As an accidental tooth wound. 

These cases are not very infrequent, and research shows, that 
reports on the subject have been made by nearly seventy writers, 
with a total of at least 100 cases, as will be seen in the Synopsis of 
Literature. The only monograph on the subject, as far as is 
known, is that of Lesage, which covers the ground very com- 
pletely. 

Many cases of the first variety are on record, and need not be 
quoted here. As illustrative of the second variety, that of infec- 
tion by a bite in defence or assault, the original case of Mr. V. E., 
(Case CIX. ) Chapter IV. may be referred to ; here the entire left 
auricle was involved in a huge chancre, as the result of a bite, re- 
ceived from a syphilitic man, in a fight. Zeissl 8 ' 9 reports several 
interesting cases, and Lavergne and Perrin, 2 give five cases of 
this nature, from the service of Fournier; one of these is almost 
an exact counterpart of the last-mentioned case, the man having 
a monstrous ulcerative chancre of the left ear from a bite ; in the 
other cases the cheek, the neck, the right arm, and the left middle 
finger, were the seat of chancres from bites. 

Chancres arc occasionally acquired from tooth wounds, made 
accidentally. Of this we have an instance in Chapter IV. , Case 
CVII: here a young man in play struck his hand against a room- 
mate's teeth, and inflicted a tear nearly an inch long, upon which 
a chancre developed within a month. His friend was under my 



I5 2 SYPHILIS INSONTIUM 

treatment at the time, and had his mouth full of mucous patches, 
and was well aware of the danger of infection. Hutchinson 28 
has twice seen chancres in policemen, who have become wounded 
in scuffles with infected men, and the Museum at the Hopital St. 
Louis in Paris contains a model of a hand with a chancre on the 
knuckle, acquired from a blow on the tooth of a syphilitic man. 
Infants with hereditary or acquired syphilis, sometimes communi- 
cate the disease by bites, as in the case reported by Drysdale; 2 in 
this instance, a hereditary syphilitic yearling bit its nurse on the 
lip, and thereby infected her, and she in turn infected her sister, 
13 years old, with whom she slept. Snowball mentions a case 
where a young woman in playing with a young syphilitic child, was 
struck upon the nose by its incisor tooth, and a chancre developed 
in the spot, followed by constitutional syphilis. Clements reports 
an instance, where a husband bit his wife in play, and caused a 
chancre. Rollet 10 states that he has on several occasions, known 
syphilis to be purposely communicated through biting, the person 
being actuated by malice, and desiring to give syphilis to the 
other. 

2. Infection by digital contact. Two phases are seen here: 

1 st. When an individual acquires a chancre by digital contact 
(other than venereal) ; and, 

2nd. When an individual inoculates another person by digital 
contact. 

Most of these cases occur in the practice of medical and surgical 
men and midwives, and also in the care of infants ; the subject will, 
therefore, be more treated of under syphilis brephotrophica and 
technica. But instances also occur among the laity, as when 
friends care for each other, or in family relations Taylor 24 
reports a case of chancre of the index finger from dressing a 
friend's chancre, Wood 2 records the case of chancre of the finger 
in a barber, and Moure 1 relates a case of chancre of the septum 
of the nose in which the poison was supposed to be conveyed by 
the finger. Others have also reported cases of this nature. 

Scratching and pinching afford some of the most striking in- 
stances of digital infection. Bryant 7 gives the case of a man 
who received a chancre on the cheek from a scratch inflicted by a 
fellow workman; and Plumert 7 a case of chancre on the breast 
in a male, following a scratch made by a syphilitic room-mate. 
Weinberg x mentions the case of a man who received a chancre on 



INFECTION IN INDUSTRIAL RELATIONS 153 

the right cheek, upon the site of an excoriation, from a pinch, 
given by a room-mate who had a chancre of the penis. 

4. Infection by passive contact, other than venereal. Several 
instances are on record where the virus has entered the skin at very 
unusual points, and from innocent contact with syphilitic lesions, 
in bed and otherwise. Some of these cases will be noticed in the 
next chapter, on syphilis brephotrophica, as many of the instances 
occur in connection with young children. Hulot reports the case 
of a man, who had a chancre in the region of the hip, from sleep- 
ing with a young man who had moist syphilitic lesions of the 
penis, with enormous paraphimosis; he was often conscious of 
touching him and of scratching the part touched, whereby the 
virus gained ready admission. MAURiAC 7a records the case of a 
man, who, while avoiding having connection with his wife, on 
account of his recent syphilis, was still the means of giving her a 
chancre on the lower part of the lumbar region. 

Many cases are on record of the communication of syphilis by 
the contact incidental to carrying and supporting infants, affected 
with the disease, which will also be more properly treated of in 
the next chapter. Certain other cases are, however, on record 
where the disease was acquired from carrying adults. Pellizzari ™ 
reports a chancre of the sub-maxillary region from contact with 
chancre on the chin, and a most striking one is reported by Rizat, 1 
who saw a patient with a chancre of the back of the neck, which 
resulted from carrying a woman astride the neck, she having 
vulvar syphilitic lesions. 

We come now to the second great group of this class of syphilis 
economica, namely such infections as occur in connection with vari- 
ous industrial pursuits, to which the term industrial transmission 
may be applied. 

2. Infection in Industrial Relations. 

This group may be conveniently considered as it relates to 

1. Buccal infection, 

2. Digital infection. 

1. Buccal infection in industrial relations. This class may 
again be subdivided as it relates to 1. Occupations requiring the 
use of the breath, and 2. Occupations where necessary or unneces- 
sary use is made of the lips. 



154 



SYPHILIS INSONTIUM 



i . Industrial infection by occupations requiring the use of the breath 
(glass blowers, assayers, weavers, musicians, conductors, house- 
maids). 

In 1859 Rollet 12 first called attention to the communication 
of syphilis from one glass-blower to another, and, in 1863 Viennois 
published his celebrated memoir on the subject, collecting thirty 
cases, twenty of which were from the epidemic at Rive de Gier, 
where the first cases seen by Rollet belonged. Numerous cases 
have been reported since that time, amounting to at least 162, 
in France, England, Denmark, and Austria. In 1881 Guinand 
collected the data relating to the subject, and urged strongly the 
periodical sanitary visitation of the factories, as a means of the 
prevention of the spread of syphilis in them. In some of the epi- 
demics the disease caused much havoc outside of the factories ; at 
one time, when twelve or fifteen men were infected, there were 
also five or six of their wives, and many children, four of them 
new-born, who acquired the disease from them. Since the first 
announcement of this method of infection, numerous single cases 
or groups of cases have been recorded by at least thirty observers, 
and I am told that cases of this kind have been observed in New 
York city, but believe that the cases have never been published. 

Sigmund n narrates a case where a chemist received a chancre of 
the lip, from a blowpipe which had been used by an infected com- 
rade, and mentions another instance, seen some years previously, 
where two persons had been infected in a like manner, from a 
single person. Margoniner 2 reports a case where a goldsmith 
acquired a chancre of the hard palate by similar means. 

F. J. Behrend 1 states that the entire family of a weaver in 
Berlin became syphilized by all members using the same tube in 
the mouth for sprinkling cloth. 

Sigmund 16 reports the case of a man who acquired a chancre 
of the lip through the medium of a bassoon, his teacher having 
mucous patches of the lips ; Arthur 4 also gives a case, con- 
tributed by Greenleaf, of chancre of the lip in a soldier, acquired 
by means of a bugle used by another who had mucous patches of 
the lips, as shown by confrontation. Two cases have also been 
repotted from the clarionette, by Lesage 4 and Pospelow, 6 and one 
by Viguier, from a flute. 

A whistle is reported by Gros as having been the means of 
communicating syphilis to a railway-guard, who borrowed it from 



INFECTION BY WHISTLES, PENS, PENCILS, ETC. 155 

a friend, to use in place of his own, and acquired a buccal chancre 
thereby; and Taylor also records a chancre from a conductor's 
whistle. 

A case is mentioned by Martineau, and quoted by Guinand, 9 
where a servant girl contracted syphilis through the mouth by 
means of a speaking-tube in the hotel where she was employed ; and 
E. Vidal reports a similar case. 

2. Industrial infection by the necessary or unnecessary use of the lips. 

Spoons as a medium of communication of syphilis, have been 
already referred to ; cases have been reported, where cooks have 
been thus infected, which need not be detailed here. 

A curious method of transmission of syphilis, has been recorded 
by Poray-Koschitz, 1 where three furriers acquired chancres on the 
lips, by means of the thread which was drawn through the lips 
and bitten off ; the thread abraded the lips, and at the same time 
conveyed the poison. 

An instance of chancre of the lip, arising through the agency 
of upholsterers' tacks, is reported by Spillman. 2 A boy, 13 years 
old, worked in company with a man, who on confrontation was 
found to be syphilitic, with the mouth full of mucous patches. 
They both were accustomed to put a handful of tacks in the 
mouth, using such as were necessary, and returning the rest to a 
common receptacle; in this manner, tacks covered w T ith saliva 
from his comrade, readily abraded and inoculated the lip. Steele 
has recorded a sim lar case, and Pospelow 7 one of a chancre of the 
tongue where the poison was conveyed by shoemakers' pegs held in 
the mouth. Guntz 6 has reported a case, where a maker of artifical 
flowers was infected through the handiwork, receiving a large 
chancre of the lip. 

Pens, pe?icils, coin, etc. Pens and pencils have been reported as 
the conveyors of the virus, by a dozen observers, Dahne, Ricord, 
Sigmund, Clerc, Otis, Bangs, Rohe, and others, and need not be 
specially mentioned here. Leloir 13 narrates a case, where a 
merchant under his care had received a chancre of the lip, from 
a piece of lip-gum or paste, which had habitually been used by 
a clerk, affected with buccal syphilides. 

Robinson 2 has recently mentioned a case, where a chancre of 
the lower lip was apparently acquired from coins, which the girl, 
who was engaged in a coffee tavern, was in the habit of biting, 
and holding in the mouth ; he states that her lover was free from 



156 SYPHILIS INSONTIUM 

syphilis, and that she had not been kissed by any other man for 
many months. As far as can be learned, but two cases are 
on record, by Desnos 1 and Fitzgibbon, 1 of the supposed communi- 
cation by bank notes, which is not a little surprising, considering 
the frequency with which the fingers are wet on the tongue, in 
handling paper money. 

2. Digital infection in industrial relations. The next group 
of cases refers to the acquisition of syphilis, in an occupa- 
tion, by means of substances handled, and relates mainly to 
laundresses and handlers of cast-off clothing. The dangers from 
washing the clothing of syphilitics is infinitely less than is 
commonly supposed, and relatively very few instances have been 
recorded, and none of these are much more clear or satisfactory, 
than the original observation recorded in Chapter IV. (Case 
LXXVIL). C. Boeck 11 is quoted by Homolle, in regard to a young 
woman, who very probably contracted a chancre of the finger, 
from handling and washing the soiled linen of her brother, who had 
syphilis. Clerc 3 reports the case of a woman, who washed the 
clothing of "fast women," who had a chancre of the caruncle of 
the left eye; her husband was examined, and found perfectly 
healthy, and it was supposed that she had possibly wiped the eye 
with some of the soiled linen. 

Hamande reports a similar case, of a chancre on the left lower 
lid, at the centre of the margin, in a washerwoman, employed in 
the laundry where the wash for the syphilitic wards was done. 
Dornig records a case of chancre of the right under lid in a washer- 
woman, but does not indicate the mode by which it was acquired. 

Fournier 40 mentions a case of a married man, 45 years old, 
who had not been exposed to contact, and was thought to have 
acquired a chancre on the right little finger, from assorting rags. 
The finger had been slightly injured, and he failed to protect it; 
he had noticed that some of the rags were stained with blood and 
discharges. 

The only case which can be found among handlers of cast-off 
clothing, occurs in an old book by Coyttarus 1 on epidemic and con- 
tagious purpura, as it was called. A female attendant in the 
sweating room, where venereal disease was treated, acquired the 
disease by working over clothing, to adapt it for herself, and her 
sister, with whom she slept, was also infected, the disease begin- 
ning on the hand. 



INFECTION IN IND USTRIA L RELA TIONS 157 

In the groups of cases which we have been studying it is seen 
that s) T philis has been communicated under the most varied 
conditions of domestic, social, and industrial life, and by means 
relating to every day life and occupation. The modes and methods 
whereby the poison has been transferred from one person to 
another were not such as would ordinarily be thought to be 
fraught with danger to health, and in- the vast majority of cases 
no harm was feared and no danger suspected until the disease had 
already manifested its existence in the individual. 

Our next chapter relates wholly to the communication of syph- 
ilis in connection with the nourishment and care of infants and 
small children, to which the name syphilis brephotrophica is given; 
here we will find even greater exposure, and if possible, still more 
frequent contamination with the disease under consideration. 



CHAPTER VIII. 

B. SYPHILIS SPORADIC A (CONTINUED). II. SYPHILIS BREPHOTROPHICA. 

1. SYPHILIS COMMUNICATED IN CONNECTION WITH NUTRITION 

OF INFANTS. 2. SYPHILIS PROPAGATED BY 
ATTENDANCE ON INFANTS. 

The material treated of in this chapter is divided into two 
great classes of cases : 

i . Where syphilis is acquired in connection with the nutrition 
proper, of the child, and, 

2. Where infection occurs in connection with the care of the 
child during its infant life. 

Each of these classes will be seen to be divided into two 
groups, and each of these again into several divisions ; these are 
then still further subdivided, until finally, we have nearly forty 
separate headings, relating to the different conditions or phases 
of the subject. These groups will now be considered in detail. 

i. Infection in connection with Nutrition of Infants. 

The section relating to nutrition of infants, embraces two 
divisions, relating to, ist. Lactation, and 2d. Hand-feeding. 

I. Syphilis communicated by Lactation. This may be consid- 
ered under two main headings : 

1. When the nurse is infected by a nursling, and, 

2. When the nursling is infected by the nurse, or by another 
nursling. 

Under each of these, there are a number of points to be con- 
sidered which will be taken up in order. 

It is not the purpose of the present study to enter into the 
subject of the transmission of syphilis by heredity, and the vari- 
ous questions connected therewith ; these have from time to time 



EXCEPTIONS TO COLLES" LAW 159 

occupied the thought and labor of some of the ablest minds in the 
profession, and much has been written to sustain quite opposite 
views on many subjects, some of which cannot be considered as 
yet fully settled. This is not the place to discuss these matters, 
nor will the attempt be made to pass judgment in regard to the 
points which may be necessarily referred to. The object in view 
is to present the matter of syphilis insontium, from its clinical 
aspect, as related to the nourishment and care of infants. The 
reports of cases and statements of different observers, will, there- 
fore, be given upon their own merit. 

1. Syphilis communicated to nurses in lactation. When the nurs- 
ling is hereditarily syphilitic, we have first to mention a few cases 
on record, where the nurse-mother is reported to have been 
infected by the child, in apparent contradiction to what is com- 
monly known as ' ' Colles' law. " It should be stated, however, that 
what has been called " Colles'. law, " and which was formulated 
originally by Diday, as follows: "A child born syphilitic through 
the agency of its parents, never communicates the disease to its 
mother, who suckles it," 1 was not stated in such strong language 
by Colles. The latter only says, 2 " As yet I have not seen any 
instance, in which an infant infected by the mother, communi- 
cated a venereal ulcer of the nipple to her. " 

This subject has been recently discussed very fully by 
Michaelson, 3 who among other cases, quotes the following 
observed by Dr. Luth, and reported by M. Zeissl : * A man, 
aged 22, married in the full bloom of early syphilis; the wife 
remained healthy, and gave birth to an apparently healthy child, 
who at five months of age developed lesions of syphilis, with 
rhagades at the corners of • the mouth. A month later, the 
mother, while nursing her child, developed a characteristic 
chancre of the left breast, followed by eruptions and other lesions 
of syphilis. Guibout 5 reports the case of a woman who bore a 
syphilitic child, without herself showing signs of the disease. 
She nursed the child and acquired four chancres of the left 
breast, one of, them indurated, as diagnosticated by Fournier. 
Jullien 12 gives an unpublished case of P. Pellizzari as follows: A 
syphilitic man had three children, all syphilitic, and all nursed by 

1 Diday. A treatise on Syphilis in New-born Children, etc. Syd. Soc, London, 1859, p. 180. 

2 Colles. Practical observations on the Venereal Disease, etc. London, 1837, p. 286. 

3 Michaelson. Monatshefte fur praktische Dermatologie. Bd. II. 1883, pp. 138, 179, 230, 366. 



160 SYPHILIS INSONTIUM 

their mother. She was examined repeatedly and found perfectly 
healthy, until, while nursing the third child, she became affected 
with a true hard chancre on the breast, and characteristic aden- 
opathy, followed, on the forty-fifth day, by a general eruption. 
Cases have also been reported by Bertin, Cazenave, Merz, 
Scarenzio and others. 

When the nurse is not the mother, there is no question in 
regard to infection readily taking place, and the instances of 
reported chancre of the breast given to healthy nurses, by children 
with inherited syphilis, are so innumerable that it is hardly neces- 
sary even to illustrate the subject. It may not be uninteresting, 
however, to refer briefly to the very carefully reported and conclu- 
sive cases of Dr. Egan, 1 which were published some years before 
Ricord accepted the doctrine of the contagiousness of secondary 
lesions ; one of his cases is as follows : A woman, perfectly healthy, 
mother of three healthy children, her husband a man of irre- 
proachable character, wet-nursed a child seven weeks old, appar- 
ently healthy at the time. A week later an eruption, afterwards 
recognized as syphilitic, appeared on the child, and mucous patches 
subsequently developed in the mouth ; from these, a month later, 
the woman acquired a chancre of the left nipple, followed by 
severe constitutional syphilis. 

When the nursling has an acquired syphilis, it may of course 
infect its mother, its wet-nurse, or others with equal facility. In 
these cases of acquired disease, the syphilis may have been gotten 
by the child in a number of ways: ist. In lactation, by having 
previously suckled some other nurse, who was syphilitic; 2nd. 
The child may have acquired the disease by kissing, or from a 
nursing-bottle, or from other infection through the mouth ; or 3d, 
The child may have become infected by vaccination, circumcision, 
or other inoculation through the skin. 

Numerous examples occur in literature, of the transmission of 
acquired syphilis by lactation, and the history of epidemics of the 
disease, as portrayed in Chapter VI., is full of instances where a 
single child with syphilis, acquired in some innocent manner, and 
unrecognized at the time, has been the means of spreading the 
disease, far and wide, primarily through the agency of lactation. 
Some very striking illustrations of this will be given later, in con- 
nection with other modes of transmitting syphilis, such as vaccina- 
tion ; a single instance illustrative of the brephotrophic spread of 



INFECTION OF NURSES 161 

syphilis, reported by Barillier may be mentioned here. An 
hereditarily syphilitic infant communicated the poison to its wet- 
nurse, giving- her a chancre of the nipple; she in turn transmitted it 
to two healthy nurslings, one of whom shortly died; the other 
infant communicated the disease to another nurse, who suckled it 
three or four times ; and she, again, gave it to another child at her 
breast. For clearness this may be presented in graphic form, as 

follows : 

C. F. (a syphilitic infant) 

gave the disease 

to 

I 
Its nurse (chancre of nipple) 

she gave it to 



Nursling, Marie S. (by lactation) Nursling, P. C. (by lactation) 

(child died) who in turn gave it 

to 

I 
Nurse, Cath. S. (chancre of the nipple) 

who gave it to 

Nursling, L. L. P. (infection per os ) 

Many illustrations could be cited, some of them even more 
striking than this, and instances are on record where large com- 
munities were infected with syphilis, starting from a single dis- 
eased infant, as may be seen in the table of epidemics in Chapter 
VI. The most extensive of these, perhaps, was that already 
alluded to at Capistrello in Italy ; here a nurse was syphilized by 
suckling a foundling, and she gave the disease to the members of 
the family, through household utensils ; in eight years, the disease 
had so spread, that, in the community of three thousand inhab- 
itants, three hundred were estimated to be the subjects of syphilis. 

A notable epidemic, the so-called Pian de Nerac, which occurred 
in 1752, and was reported by Raulin, was of this nature; as it 
was of such peculiar interest, and has been so often only briefly 
referred to by writers, an abstract of its features may not be with- 
out interest. 

The wife of a merchant in the town of Nerac, in the South- 
west of France, who was perfectly healthy, gave her child to be 
nursed by a woman, who was also healthy; at the end of six 
months, the wet-nurse being sick, one of her neighbors gave her 
breast to the child five times, and very shortly it became ill, and 

12 



162 SYPHILIS INSONTIUM 

had an eruption. The parents then took the child away, and 
while suckling another wet-nurse y the child suckled also several 
women of the neighborhood; the child had many sores in the 
mouth, and very extensive and deep, pustular and ulcerative 
lesions on the body, one of which perforated the tracheal artery, 
and the child died. All the women who had nursed the child 
soon acquired sores on their breasts, and general eruptions, and 
their infants became similarly affected. The contagious nature of 
the malady was not suspected, and a number of other nurses 
suckled these children, and they, and their infants, became in- 
fected ; so that, by the expiration of a year, there were more than 
forty women and children infected, in addition to a number of 
husbands, and also others, who did not disclose their malady, 
because it had become to be regarded as venereal. From the 
description given, it is probable that scabies was also mingled 
with syphilis, in some of these cases, on account of the short period 
which often elapsed after exposure, and the character of some of 
the eruptions, which also often presented very great itching; but 
some of the infants died, and from the mouth lesions, etc., there is 
no doubt but that the main disease was syphilis. 

Other epidemics are reported of various proportions, where 
1 6, 1 8, 23 and more individuals acquired the disease, started by a 
single syphilitic child, as may be seen by a reference to the 
Synopsis of Literature. One more single instance of a smaller 
epidemic may be given in detail from Dron, 6 as illustrative of the 
manner in which the contagion is spread. 

Mad. X. obtained a nursling, which , at a later period exhibited 
syphilitic symptoms and died at three months of age. To ease 
her breast she gave suck, for a single night, to an eight-day old 
child belonging to a neighbor, Mad. P. , and, as this infant did not 
satisfy her, she borrowed two or three more children in turn. Mad. 
P. acquired chancre of the breast, and she and her infant had 
syphilis ; later she aborted, and her husband took the disease from 
her, through a chancre on the penis. The next child, that bor- 
rowed of Mad. M., was 4 months old, and took the breast but 
twice ; this infant was infected, the mother had chancre of the 
breast, and her husband also acquired the disease. The third 
child borrowed, an eight-months boy of Mad. T., received a 
chancre on the tongue and infected its mother who bore a dead 
child at her next pregnancy, and who also infected her husband. 



INFECTION OF NURSLINGS 163 

Mad. X., who was the first agent in introducing the disease, had a 
very protracted attack of syphilis, aborted at her next conception, 
and also communicated the disease to her husband ; thus eleven 
persons acquired syphilis through the one child. 

Put in tabular form this series of cases stands as follows : 

Infant syphilitic nursling (died of disease) 

infects 

I 
Madame X. (who aborts) 

infects 

I 

Infant P. Infant M. Infant Y. Her husband, 

infected infected infected 

Mme. P. (who aborts) Mme. M. (who aborts) Mme. Y. (who has still-born child) 

infected infected infected 

I I .1 

Husband (chancre of penis). Husband. Husband. 

It will not be necessary to further illustrate this portion of the 
subject; the disease is, of course, spread in the same, or similar 
manner, when the child acquires syphilis by kissing or in some of 
the various manners to be mentioned later on ; the cases where 
the disease starts from vaccination, circumcision, etc. , will be con- 
sidered in connection with those subjects in the next chapter. 

2. Syphilis communicated to nurslings by nurses or by other nurslings. 
Three main divisions occur here : 

1 st. When the nurse has a chancre or other syphilitic lesions 
on the breast. 

2d. When she has recent syphilis but no lesions on the breast, 
and 

3d. When another nursling is the syphilifer, the nipple acting 
only as a means of conveying the poison left upon it. 

The cases where the nurse has a breast chancre, from lacta- 
tion, are naturally very closely connected with the preceding 
section and need not be noticed here. The chancre may also 
have been acquired by kissing, as indicated in the preceding 
chapter, and has also repeatedly occurred inconsequence of breast- 
drawing, as will be developed and illustrated in the next chapter 
on Syphilis technica. 

The lesion on the nurse's breast need not be a chancre, but 
may be mucous patches, dependent, perhaps, upon an ordinary 
venereal syphilis. Repeated instances have occurred where the 



164 SYPHILIS INSONTIUM 

infected nurse has been the starting point of a group of cases, 
perhaps none more striking than one recorded by Ambrose Pare, 
in 1575, long before modern sy philology had established many of 
the methods by which syphilis is propagated. A lady took a wet- 
nurse to share the labor of nursing her infant. This nurse infected 
the infant, the infant communicated the disease to its mother, she 
to her husband, and he gave the disease to his two children, aged 
respectively three and four years. In tabular form this appears 

more clearly: 

Nurse (with syphilitic eruption) 

infected 

I 
Nursling (who died) 

infected 

Its mother (chancre of the nipple) 
she infected 

Her husband 
he infected 

I 

I I 

Child, aged 3 years Child, aged 4 years. 

When the nurse has not active lesions, and the nursling has 
acquired syphilis through her, it has been thought that the infec- 
tion has taken place through the ageney of the milk, and cases 
have been reported in support of this view, notably those of 
Steinberger and Cerasi. * It seems hardly necessary to quote these, 
however, in view of the fact that all modern writers agree that syph- 
ilis cannot be communicated by the milk alone, as the following 
case, from Lee, 1 would seem to show pretty conclusively : A married 
woman took a strange child to nurse, giving it one breast and her 
own child the other, most carefully. She acquired a chancre on 
the breast given to the foundling, but although her own child 
continued to nurse the other breast for six weeks after she devel- 
oped a syphilitic eruption, it entirely escaped infection. The 
subject has also been thoroughly studied by Gallois, 2 who arrives 
at the same conclusion. 

The nipple sometimes serves as the mediate means of conta- 
gion, conveying syphilis from one child to another, without the 
nurse becoming infected. Of this an instance is recorded by 
Bertin, 3 where a healthy mother gave her breast to the child of a 

1 Lee ( 8 ) cited by Baumler— Syphilis-Ziemssen Handb. 2d Edit., Bd. III., 1886, p. 44. 

2 Gallois — Recherches sur la question de l'innocuite du lait, etc. Paris, 1877. 



INFECTION BY FEEDING BOTTLES, ETC. 165 

syphilitic woman, and her own child became diseased at the age 
of three months, and showed many signs of constitutional syphilis, 
while the mother, who was under observation for a long period, 
escaped entirely. 

II. Syphilis communicated through hand-feeding. (By feeding- 
bottles, sugar-teats, cups, spoons, etc.) The various implements 
which are used in feeding the infant may all, at times, serve as the 
medium for transmitting syphilis, and literature abounds in well 
authenticated cases where this has occurred. The infection may 
occur in two different directions. 

1 st. Where the foster-mother or attendants are infected from 
the infant ; and 

2nd. Where the infants are infected either by the adult, or 
from another child, who is syphilitic. 

Hutchinson" has recorded a case, where a woman bore a 
number of syphilitic children, as a result of the disease acquired 
before marriage. Her husband escaped infection until he acquired 
a chancre of the tonsil, from his habit of starting the feeding-bottle, 
in the night, for his fourth child, who was at that time suffering 
from a syphilitic mouth. Spillman 1 also reports a case of chancre 
of the tonsil, in a lady 59 years of age, acquired by always tasting 
the nursi?ig-bottle of a syphilitic baby, whom she tended; and 
Fournier 31 mentions a case of Hilliaret's, where a grandfather 
and grandmother both had chancres of the lip, from a. feeding-bottle 
used by a syphilitic child, who had already infected its wet-nurse. 
He also relates the case of another grandmother, 65 years of age, 
who acquired syphilis from the spoon, with which she fed a 
child, always carrying it to her own lips first. Gibert 4 gives an 
instance where a mother and her own infant acquired syphilis from 
a nursing-bottle, used by a foundling; and Fournier is credited by 
Audovxaud 4 with a case, where the nursing-bottle was infected by 
a working-woman, who chanced to come in and taste the teat, she 
having secondary syphilitic lesions. Plumert 5 reports concerning 
a mother and child, who acquired syphilis from the same sugar- teat, 
infected by some unknown third person; and Sigmund 16 records 
two children infected from a third infant, by the same means. 

Spoons and cups are not infrequently the means of carrying the 
poison of syphilis among children, and their attendants, even more 
than occurs among- adults. Ricordi x says, "It is the custom, 

1 Ricordi. Syphilide da Allattamento, etc. Milano, 1865, p. 36. 



1 66 SYPHILIS INSONTIUM 

especially in the country, to give to the nurslings who have passed 
the fourth month, a pap of bread and milk. This duty is mostly 
reserved to the oldest people in the household, who carry the 
grandchildren in their arms, and before inserting the pap in the 
children's mouths, touch it to their own lips, to test the tempera- 
ture of the food. Frequently the infants and other children are 
participants of the frugal meal, offered with the same spoon. So 
one is infected from others, mouth to mouth, and nursing children 
infect the nurses. This mode of infection I have seen many times, 
and it was the occasion of the epidemics in 1862 at Premezzo, 
where there were 9 victims, and at Castellanza, where 11 were 
infected." Diday 1 relates and quotes a number of cases, where 
the disease was acquired from spoons used in feeding syphilitic 
children : in one instance the nurse, her daughter, and her mother, 
three generations, were all infected by this means. Roussel also 
quotes several instances from Lagneau and others. Vidal de 
Cassis records an instance where he found four out of six little 
children, in a weaning establishment, infected by the single glass 
used for the six, in common with a syphilitic child, who had 
acquired the disease from her wet-nurse ; he further quotes a case 
from Lucas-Championniere, where a mother and her two daugh- 
ters acquired syphilis from the same spoon and glass, used by 
a two-year-old syphilitic foundling, whom she had taken in 
charge. 

Another method of communicating syphilis to small children, 
which has been reported by Boeck, 15 relates to a practice common 
in some localities, of chewing the infant's food before putting it in 
its mouth, and also warming milk in the mouth before giving it to 
the child : Bataschoff and Cold have reported similar cases. 

2. Infection through Attendance on Syphilitic Infants. 

We come now to the second great section of this class of cases, 
namely, infection through attendance upon syphilitic infants. Here we 
find an infinite variety of modes, whereby the poison can be trans- 
ferred from one to the other ; the innumerable acts of care and 
attention bestowed upon the new-born child, all serve, on proper 
occasions, to favor inoculation, while the tender nature of its 
tissues, favors the abrasions which allow of infection. The sub- 
ject may be considered under two great divisions, according as 
the infection takes place: 



INFECTION BY SPONGES, SYRINGES, ETC. 167 

1 st. Through mediate contact. 
2d. Through direct contact. 

I. Infection by mediate contact (wash-water, sponges, syringes,, 
combs, napkins, clothing, cradle-lining, etc.). Kobner 3 reports a 
rather doubtful case, where a child 2-1- years of age, was infected 
after bathing in water used by her father, recently syphilitic, with 
lesions between the toes; the communication of the disease by 
wash-water, however, appears not improbable from instances to be 
cited in the next chapter. 

Sponges, have been reported as conveying the infection, by 
several observers. Cullerier 2 records a case where a woman 
affected with chancres of the vulva, communicated them to her 
daughter, three years old, by washing her with a sponge which she 
had just used for herself. Huguier 2 reported a case where a 
mother, with mucous patches on the vulva, inoculated her two 
little daughters by the use of the sponge which she had used in her 
toilet. Pontet x gives a case from the service of Fournier, where 
an infant, born at the " Maternite," was infected by being washed 
by an inmate, with a sponge which had served in the ward for other 
infants affected with syphilis. 

Syringes are reported as conveying syphilis between children, but 
no cases are at hand sufficiently clear for illustration. This method 
of communication has been illustrated in the preceding chapter. 
The case of infection by a comb, reported by Pellizzari, has been 
given in the preceding chapter. The same author 3a reports the 
case of an infant infected with a chancre of the anal region, by 
means of a piece of cloth; similar cases are reported by Diday, 
Lavergne and Perrin; Peter Bolschwing 5 gives the case of 
an infant who was repeatedly placed in the cradle of a child of 
other parents, with a suspicious eruption, and who shortly devel- 
oped sores on the mouth, from which its nursing mother received 
a chancre of the breast; and Cusack reports the case of infection 
of an adult by the bedding of a syphilitic child. 

II. Infection by direct contact. This section, as in the preced- 
ing chapter, is divided into, 

1 st. Infection by active and limited contact, and, 

2d. Infection by passive contact. 

1. Infection by active and limited contact. Here again three divi- 
sions may be made according as the infection is 1. Buccal; 2. 
Digital; 3. Aerial. 



1 68 SYPHILIS TNSONTIUM 

i. Infection by buccal contact. The principal method of giving 
and receiving syphilis directly by the mouth, in the case of 
infants, as already seen in the case of adults, is through kissing; 
this may happen in three directions: ist. Adults infected by 
children,; 2d. Children infected by adults; 3d. Children infected 
by other children. As in the case of adults, already mentioned 
in the preceding chapter, the lesions may occur on the lips, 
or on other parts of the body. The cases of chancres of the 
lips, caused by transmission of syphilis between infants and 
adults, are so numerous, and the subject is so well understood, 
that it is hardly necessary to develop the matter here. We may 
mention, however, the instance of Rollet's, 9 quoted by Roussel, 
where an infant of 15 months, who was kissed by a prostitute, and 
infected thereby, communicated syphilis to her two brothers, her 
two sisters, and her grandmother. The same writer quotes a case 
of Cunier, where a child received a chancre of the eyelid, likewise 
from a kiss by a prostitute, who had a chancre of the lip. Egan s 
reports a case of a chancre of the neck, on a nurse 60 years old, on 
the site of a scratch ; she had been accustomed to have a syphilitic 
infant go to sleep with its mouth just over the scratch ; Egan 4 
also gives a case where a woman, acting as a dry-nurse to a syph- 
ilitic child, acquired a chancre of the lip, she acknowledging that 
she both kissed the child, and more than once applied her lips to 
sores which the child had about the anus. Chancres from acci- 
dental tooth-wounds given by children, have been mentioned in 
the preceding chapter. 

2. Infection by digital contact. This may occur in two different 
directions, and under several different conditions: ist. The adult 
being infected from a child, and 2nd, The child receiving the 
infection from the adult ; of each of these many instances are on 
record. First we will consider the subject of chancre on the finger^ 
in the adult. It is generally considered that wet-nurses acquire 
chancres only on the breast, but Auspitz quotes Schuller 1 in a 
case, where the syphilis of the nurse began with a lesion on the 
finger; and, as illustrating the other aspect of the proposition, we 
may refer to Sigmund 9 ' 10 who records an instance where a midwife 
with chancre of the finger infected her own child with a chancre in 
the angle of the lips, by inserting the finger to cleanse its mouth. 

There are still other series of cases, which illustrate the opera- 
tion of the finger as a mediate object, in conveying the syphilitic 



INFECTION BY DIGITAL CONTACT 169 

poison, between infants and adults. These cases may be grouped 
into four categories : 1st. The adult free from syphilis becomes 
infected by means of the finger; 2nd. The adult syphilitic infects 
an infant ; 3d. A healthy infant infects itself from an adult, by the 
finger; 4th. A syphilitic infant infects an adult. The first of 
these will come more properly in the next chapter, on syphilis 
technica. The second division is well illustrated by two cases re- 
ported by BAUDRY; x ' 2 in one of them a child, 25 months old, re- 
ceived a chancre of the right lower eyelid ; the child having con- 
junctivitis, the nurse's sister-in-law rubbed its eyelids with her 
finger, moistened with her own saliva, her mouth being found 
full of mucous patches. In the other case, a child, 4 years old, 
received a chancre on the left upper lid from her syphilitic mother, 
who, with mucous patches on the mouth and tongue, did the same 
action. Other somewhat similar cases are reported. 

The third variety of infection is illustrated by a curious case 
reported by Pontet, 3 from Fournier's clinic. A child, 18 months 
old, acquired a chancre of the tongue, from its habit of poking its 
own finger into the mouths of others and then into its own mouth ; 
the nurse to whom it was occasionally committed was found to 
have mucous patches at the corners of the mouth, and in the throat. 
Barensprung, 3 records a case, where an infant, 16 months old, 
recovering from varicella, scratched himself, and inoculated the 
inguinal region, from mucous patches existing on the genital and 
anal region of its mother, with whom it slept. 

As an illustration of the fourth variety of infection, we may 
refer to the following case reported by Sturge: 2 An infant with 
syphilis, was in the habit of putting its fingers into its own 
mouth, and then into the mouths of others, and in this manner 
inoculated its father, mother, god-mother, and several others, who 
received chancres of the lips or tongue. 

3. Aerial transmission of syphilis. Mention has been made by 
writers, of syphilis having been communicated by blowing or 
sputtering in the face, the virus coming with the saliva from 
mucous patches in the mouth , but no satisfactory cases can be 
quoted ; although in the next chapter instances will be mentioned 
where infection has taken place by aerial transmission of the 
virus. 

2. Infection by passive contact (during parturition, innocently 
in bed, and by contact in carrying). The cases coming under this 



170 SYPHILIS INSONTIUM 

class may be placed in three groups : 

i st. Infection in parturition (from the mother); 

2d. Infection during slumber ; 

3d. Infection by contact in arms. 

Although many have questioned, if the infant could be infected 
from the mother's parts during parturition, several cases have been 
reported which seem to point to its possibility. Guibout 1 de- 
scribes the mode of its occurrence minutely, as though he had 
seen it himself, and Benjamin Bell 2 states that he has known 
different instances of the same. Ricord 3 also acknowledged its 
possibility. Weil x reported a case of chancre of the root of the 
nose four weeks after birth, from a mother suffering from condy- 
lomata of the labia ; Carreras records an instance of chancre of 
the inner angle of the eye in a new-born child, and Thiry 6 a 
chancre on an infant acquired during accouchement. Grunfeld 1 
gives a case, where a child eight weeks old was found with a 
chancre on the scalp, the mother having lesions on the genitalia, 
she having received her syphilis in the middle of pregnancy; 
and Poncelet reported a case of similar infection, said by the 
reviewer (Zeissl) to be complete in detail. 

Numerous instances are on record, of syphilis being trans- 
mitted between adults and infants in bed, one of which was just 
noticed in connection with scratching. Trousseau x mentions one 
case, where a little boy, of 4 months, had a chancre on the 
buttocks, acquired from mucous patches on his mother's vulva, he 
being in the habit of going to sleep with the buttocks against her 
abdomen. P. Pellizzari 2 records a case where a nursling acquired 
a chancre of the lower eyelid, from contact with the secretion of 
mucous patches in its mother's mouth; the mother had recent 
syphilis, and had exercised great precaution against the infection 
of the child, and the infant had slept with her but a single night ; 
on this night, however, she fell asleep on the child's side, and, on 
waking, found its forehead bathed in her saliva, which moistened 
the bed-covering continually, she having an incredible number of 
mucous patches in the mouth : many other instances are found in 
the Synopsis of Literature. 

Infection by contact with infants in the arms has occurred not 

1 Guibout. Nouvelles lecons cliniques sur les Maladies de la Peau, Paris, 1879, p. 158. 

8 Bell. A treatise on Gonorrhoea virulenta and Lues venerea, Albany, 1814, Vol, II., p. 9. 

3 Ricord. Lettres sur la Syphilis, Paris, 1863, p. 200. 



INFECTION B Y CO NT A CT IN A RMS 1 7 1 

infrequently, both in the case of, ist. Adults infected by infants, 
and, 2nd. Infants infected from adults. Waller 6 speaks of the 
case of a woman, 70 years old, who contracted a chancre on the 
left cheek, and one on the left neck, the points where she was 
accustomed to hold a syphilitic infant, in quieting her to sleep. 
C. Pellizzari 4 * reports the case of a girl of 16 years, who carried 
to the Dispensary a syphilitic child, and upon her right cheek she 
received a chancre, just where the baby rested when asleep. 
Ory m relates two instances, from the clinic of E£ardy, where girls 
contracted chancres of the forearm, from mucous patches on the 
anus of the child. Dowse records also the case of a girl, with a 
chancre of the forearm, from holding a syphilitic child ; in the end 
the case in the girl proved fatal, from nervous lesions. Cusack 8 
.gives a case where a chancre on the thumb occurred from carrying 
a syphilitic child, and Keyes l one where the arm was so affected. 

In addition to the methods of communication of syphilis between 
adults and children which have been here mentioned, there are, 
of course, many more which have either not been recorded, or have 
escaped detection; many cases are reported, where the simple 
fact of the transmission of syphilis is recorded, but no definite 
data are given, while in many more the exact methods of infection 
could never be determined. Sufficient has been given, however, 
to quite justify Fournier's remark, 1 that ' ' nothing is so dangerous 
to its surroundings as a syphilitic infant." 

1 Fournier. Syphilis et Manage. Paris, 1880, p, 211. 



CHAPTER IX. 

B. SYPHILIS SPORADICA (CONTINUED). III. SYPHILIS TECHNICA 

I. OPERATOR THE VICTIM I 2. OPERATOR THE 

syphilifer: 3. OPERATOR the medium. 

In the third great group of cases of syphilis, where the disease 
is communicated in connection with the various forms of body 
service, medical and surgical, or of like nature, we find a ready 
division into three classes : 

1 st. Where the operator is the victim; 

2nd. Where the operator is the syphilifer ; and, 

3d. Where the operator is the medium. 

These classes are again divided and subdivided, until, as in the 
preceding chapters, we find a large number of ultimate final divi- 
sions, there being here nearly fifty subjects about which cases can 
be grouped: they will be considered under the three main divi- 
sions already mentioned. 

1. Operator the Victim of Syphilitic Inoculation. 

Here we find, first, two classes of cases, according as the infection 
occurs, accidentally, 

1 st. From unnecessary exposure; and, 

2nd. From necessary exposure. 

In all of these cases, the exposure is in a measure unnecessary, 
resulting in some degree from carelessness, either in wounding a 
part, or in having an abraded surface unprotected, through which 
the virus may enter; but in the second class of cases, a certain 
amount of exposure may be necessary, from the nature of the 
service rendered, and often inoculation occurs in a manner which 
was quite unforeseen and unpreventable. A large number of 
cases are reported, simply as "professional infection," without 
details, while certain cases have been reported more fully. 



SYPHILIS ACQUIRED IN OPERATIONS 173 

Hutchinson somewhere speaks of having seen over 100 cases of 
syphilis thus acquired by physicians, and Paget is quoted as 
having seen 50 cases, of which 5 were fatal. 

1. Professional infection by unnecessary exposure. Two classes 
of cases are included here: 1. Accidental wounds in surgical 
operations; and, 2. Infection from the cadaver. 

1. Operative infectio7i. One of the most interesting cases of 
this kind is that of Mr. Coote, 3 - 4 who twice inoculated himself in 
operations, at an interval of twenty-two years : the first inocula- 
tion may have been chancroidal, although some secondary symp- 
toms were reported; the second was clearly syphilitic. Hardie 
(in the same report of the English Commission, p. 162) mentions 
the case of a physician where a second infection took place, the 
chancre occurring on the finger as the result of a wound, received 
in dividing a stricture of the rectum in a recent syphilitic. 
Zeissl 13 was inoculated in opening a bubo in a syphilitic subject, 
and Scarenzio 6 was also infected with syphilis by a digital chancre : 
the late Dr. Nott, quoted by Lydston 2 and a number of other 
physicians in this country, are known to have acquired syphilis in 
operations upon syphilitic patients: some of the original cases 
reported in Chapter IV. were of this nature. 

2. Cadaveric infection. A number of writers speak of infec- 
tion of anatomists, in dissections made on syphilitic cadavers: 
thus, Jullien 1 quotes Swediaur as having seen anatomists infected 
from the dead body, and the same is reported by Sommering, and 
also by Howard ; the latter gives the case, in detail, of a surgeon 
who wounded the finger on a splinter of bone in a syphilitic corpse. 
One of the most interesting cases claimed for this source of infec- 
tion is that quoted by Lagneau, 2 of Hourmann, physician at the 
Lourcine Hospital, who died from the effects of syphilis, received 
on the index finger of the left hand, which was wounded on a 
cadaver. Rumpf 3 and Taylor 20 have recently reported cases of 
this nature. 

2. Professional infection by necessary exposure. The next 
group of cases relates to such as occur from the greater or less 
necessary exposure to syphilitic infection, in the performance of 
acts incident to a profession or calling, and includes surgeons, 
accoucheurs and midwives, dentists, attendants, etc. The 
infection may be, 1. Manual (or digital) ; and, 2. Cephalic. 

1 Jullien. Traite prat, cks mal. verier,, 2nd Ed., 1886, p. 589. 



174 SYPHILIS INSONTIUM 

i. Infection by manual (or digital) contact. In this the infection 
may occur on the hand, or be carried by the finger to other parts. 

i. Physicians and surgeons in manipulative procedures. In the ordi- 
nary palpation of genital chancres, as well as in the examination of 
primary and secondary lesions in the mouth, and elsewhere, also 
in vaginal and rectal explorations, physicians and surgeons have 
repeatedly been infected, and the subject is so well recognized 
that it need not be dwelt upon here. Some of the original cases of 
finger chancre detailed in Chapter IV. were acquired in this 
manner. A very interesting case is related by Jullien. 13 An 
eminent specialist had a slight, bleeding lesion on the finger, and 
was called upon to examine a chancre upon the upper surface of 
the glans penis. He held the wounded finger carefully aloof from 
the sore, but, during the examination, he found that there was a 
second chancre of the scrotum, which had just come in contact 
with the abrasion which he had striven to protect. Recognizing 
the danger, he at once washed carefully, and cleansed the part 
thoroughly ; but all in vain, a chancre formed on the wounded part 
and the syphilis ran its course. Jullien argues from this, that 
absorption begins the moment that perfect contact takes place. 
Churchill reports the case of a chancre on • the palmar surface of 
the thumb, in a medical student, who frequently palpated venereal 
sores, and took no precautions against infection, but boasted of 
his continued escape. Many cases of this kind are found in the 
Synopsis of Literature. 

The infection may be by mediate objects. Cullerier 6 reports 
the case of a pupil of his, who contracted a labial chancre, "in con- 
sequence of a bad habit, which he continued, in spite of my advice, 
that of placing between his lips, the pen used in recording cases, 
and which was soiled by his own fingers, that had been placed on 
all sorts of ulcerations." Jumon 4 records a case, from Fournier's 
Clinic, where a physician used a paper-cutter as a tongue- 
depressor, on a syphilitic case with confluent mucous patches; 
neglecting to cleanse it he shortly placed it in his mouth, and 
acquired a chancre of the lip. 

2. Accoucheurs and Midwives, afford by far the largest number of 
cases of infections of this class, and, as will be seen in the next 
section, they have sometimes been thereby the innocent means of 
propagating syphilis, among others, even to a very distressing 
extent. In Chapter IV are given several cases of physicians who 



SYPHILIS ACQUIRED IN OBSTETRICS 175 

became thus infected, one of whom subsequently communicated 
the disease to his wife. Lee 9 a gives an interesting case, where 
a medical man, in performing craniotomy, had his finger between 
the bones of the foetal head when a pain came on ; the finger was 
injured thereby, and a chancre followed, with a protracted course 
of secondary symptoms ; Cairns reports a case where a physician, 
recently recovered from severe scarlatina, acquired a chancre of 
the finger, which required amputation and was followed by 
galloping syphilis. 

In certain of these cases of obstetrical syphilis, the chancre on 
the finger may be so slight as actually to escape observation, its 
presence being indicated, only by a remaining adenopathy, and 
the secondary symptoms. Hutchinson 1 and Pellizzari 2 mention 
such cases, and I have met with two instances of the same. 
Midwives have frequently been reported as acquiring digital 
chancre in their calling, and it is not a little interesting to note 
that, according to Lee, 3 this mode of infection is mentioned in the 
first treatise published in the English language upon the lues 
venerea, by William Clowes, one of Her Majesty's Chirurgeons, in 
the year 1596: he says "I have known, not many years past, three 
good and honest midwives infected with this disease, called lues 
venerea, by bringing abed three infected women, of three infected 
children; which infection was chiefly fixed upon the midwives' 
fingers and hands. " 

3. Dentists occasionally acquire chancres of the fingers, in their 
profession, although the reported cases are relatively few. 
Hutchinson 17 gives a plate representing " a well-marked, circular, 
indurated sore, on the pulp of a finger of a dentist ; it had been 
produced by a scratch on a patient's tooth." Neumann 8 also 
reported a similar case, followed by severe syphilis, and Lesage 5 
and Taylor, 11 report instances of the same ; an Anonymous 3 case has 
also been reported in Boston. A case has recently been reported to 
me by Dr. Baldwin, of Columbus, Ohio, where a dentist wounded 
one of his fingers, with an instrument called a "plugger," while 
filling a tooth; a chancre developed at the site of injury, which 
was still present, accompanied with full signs of secondary 
syphilis. 

1 Hutchinson. Syphilis. London, 1887, p. 132. 

2 Pellizzari Delia transmisione accident, della sifilide. Milano, 1882, p. 65. 
8 Lee. Lectures on Syphilis. Philadelphia, 1875, p. 35. 



I7 6 SYPHILIS INSONTIUM 

4. Infection of attendants. Chancres have also been produced in 
attendants (and likewise in physicians) on the eyelids, nostrils and 
lips, by conveying the virus on the fingers to the parts infected ; of 
these, numerous instances have been reported, which need not be 
here detailed. Wendt 3 cites the case of an old attendant, who 
carried about in his arms a syphilitic patient, with severe secondary 
eruption, who acquired on the face, not far from the nose, a 
primary syphilitic sore, of phagedenic nature. 

2. Infection by cephalic (buccal or facial) contact., Breast drawing 
and wound sucking have been the means of acquiring syphilis, by 
those who have performed these offices ; but, as these have also 
been fruitful sources of the communication of syphilis, to those on 
whom the action is performed, the subject will be deferred for full 
consideration in the next section, where the operator is the syphilifer. 

A single case only, has been found, where syphilis was acquired 
in the operation of inflating the lungs of the new-born. Wiggles- 
worth 1 reports such a case, in a physician, who had attended a 
woman in confinement, who bore a syphilitic child : the child being 
partially asphyxiated, he placed his own mouth to its lips, and 
thus acquired a chancre of the tonsil. 

Cases have been reported, where the syphilitic virus has been 
carried directly from the patient to the physician, by means of 
expired air in coughing, etc., without the intervention of any 
mediate object. Desmarres 1 reports such an instance, where a 
young physician was engaged in swabbing, or cauterizing a 
patient's throat, in which were pharyngeal mucous patches : the 
patient gagged, and projected some drops of saliva into the 
physician's face and eyes, and a chancre of the eyelid followed : 
Leloir 9 states that he has seen an example of this kind, and quotes 
Fournier to like effect. 

11. Operator the Furnisher of Syphilitic Infection. 

The next section ( Operator the syphilifer) refers to those cases 
where the operator, having syphilis, communicates the disease to 
others in various forms of body service. Here we find two main 
groups: 

1 st. Where the infection is produced by direct contact with the 
subject: and 

2nd. Where the infection is produced through a mediate agency, 
the operator infecting the instrument. 



SYPHILIS COMMUNICATED IN EXAMINATIONS, ETC. 177 

i. Infection by direct contact. The cases belonging to the first 
group are further divisible into those produced, ist. By Digital 
contact; and, 2nd. By Buccal contact, which will be considered 
separately. 

1. Infection bjr digital contact. The finger may be the means of 
transmitting syphilis under two conditions : 

1 st. When the infecting finger is the seat of a chancre; and, 

2nd. When the infecting finger is soiled by secretions, saliva, 
etc. 

1. Syphilis conveyed in chirurgical manipulation. Hutchixsox 31 
records a case where an obstetric physician with a chancre 
of the finger, examined a lady for piles, before he had suspected 
the true nature of his own sore ; as a result of this examination, 
a chancre was produced on one of the nates, "exactly where 
the finger had probably rested in opening the parts;" she after- 
wards suffered from constitutional syphilis. Clossius 2 quotes 
the case of inoculation from the finger, soiled with infected saliva, 
introduced into the mouth, for the purpose of raising the uvula. 
Broick 7 and Krellixg 2 record cases where infection was produced 
by the application of the finger, wet with saliva, to an erysipelatous 
surface. 

2. Syphilis conveyed in obstetrical manipulation. The communi- 
cation of syphilis by accoucheurs and midwives, occupies a promi- 
nent place in the literature of the disease, and is such a well- 
established fact, that it needs but little illustration here. In all 
the accounts of the endemic appearances of syphilis, as detailed in 
Chapter VI., we find it constantly noted, that the disease was 
communicated in this manner, and the table of epidemic syphilitic 
visitations, found in the same chapter, contains many similar 
instances. 

The celebrated epidemic at Saint-Euphemie, in France, 1 was 
of this nature. A midwife acquired a chancre of the right index 
finger, followed by a full attack of constitutional syphilis: she 
still exercised her calling for four months, in spite of, and during 
the existence of, the chancre, and communicated syphilis to more 
than fifty women, and through them at least thirty other persons 
were attacked. Very recently Dr. Hime reported an epidemic in 
England, where thirty married women, nine husbands, and two 
infants contracted syphilis directly or indirectly, from a diseased 

1 Rollet. Traite des mal. verier. Paris, 1866, p. 454. 

13 



178 SYPHILIS INSONIIUM 

midwife; Bardinet 6 records an epidemic in France, where over 
one hundred were infected. 

A remarkable instance is recorded by Colles, 5 where an accou- 
cheur, two years after having had a chancre of the finger, and 
after having undergone mercurial treatment, (even to a greater 
degree than usual), infected a number of women, from a second- 
ary sore on the finger, caused by an accidental injury in a window 
sash. Hutchinson 24 mentions a case where a young woman 
acquired three chancres, on the labia, from a midwife who had a 
chancre of the finger. 

A curious mode of communicating syphilis in connection with 
accouchement, was observed by Bleynie. A woman was in the 
habit of wetting her fingers in her mouth, when handling the 
umbilical cord, to recover it when retracted, and in this manner, a 
very considerable number of infants were infected with syphilis. 

It may be interesting to note, that, while in surgeons and 
accoucheurs, the primary lesion has commonly been reported upon 
the finger, and, in the latter, most frequently on the index finger, 
in midwives the larger number of cases occur on the thumb and 
elsewhere (Brambilla, Plumert, and others, on the thumb, 
Neumann, on the hand, Bardinet, on the middle finger, Engel- 
sted, one on the third finger, and two on the fourth finger, etc. ). 

2. Infection by buccal contact. Under this category come cases in 
which infection occurs : 

1 st. With an open wound ; and, 

2nd. Without any known wound. 

1. Buccal infection through an open wound. Here are included 
cases referring to wound sucking, and the practice of staunching 
the blood by the mouth, after ritual circumcision. 

Sucking of recent wounds, has on many occasions, given opportu- 
nity for the entrance of the syphilitic virus, and a number of 
cases are on record, where sucking the part, to prevent a ' ' black 
eye" from a blow, has given rise to a chancre; an interesting case 
is reported by Berkeley Hill: 1 A man aged 33, received a blow 
on the cheek in a fight, which drew blood; to prevent a black eye 
the wound was sucked by his antagonist, and quickly healed, and 
all trouble disappeared. Six weeks later, flat tubercles appeared 
on the part, which crusted over, and were accompanied by enlarged 
lymphatic glands, at the angle of the jaw on that side; constitu- 
tional symptoms soon followed. His wife was infected within 






SYPHILIS COMMUNICATED IN CIRCUMCISION 179 

two months, and she infected her nursing child, through mucous 
patches found on the right breast, the child receiving a chancre 
in the left side of the mouth. 

A curious instance is reported from Fournier's service by 
Jumon, 1 where a young woman was cut on the calf of the leg, by 
a bursting champagne bottle. Fearing lest glass should have 
remained in the flesh, a companion sucked the wound, and a 
chancre, followed by constitutional syphilis, resulted: the friend 
was examined, and found to have mucous patches in the mouth. 
Anderson, Meighan, Robbins, and Van Harlingen have also 
reported chancres from sucking wounds. 

Ritual circumcision, has frequently been followed by the inocu- 
lation of syphilis, and as will be seen in the table of epidemics, 
this practice has sometimes been the occasion of very extensive 
spread of the disease. 

The earliest record accessible in regard to this subject, is 
that given by Rust, 3 and as it details the method in which he 
made the discovery of the source of infection, it may not be with- 
out interest. In 1805, a number of new-born children in a Jewish 
institution, were found to have ulcers of the penis. Called to 
investigate the matter, Rust found that this trouble was confined 
entirely to male infants, and that almost every one circum- 
cised at that time, acquired what he recognized to be a chancre, 
resulting from the circumcision wound. The mothers, nurses, 
and attendants were examined, but no cause for the matter could 
be found. Recognizing that the sores could not come from 
venereal contagion, he concluded that it was connected with the 
ritual act, and he watched the man who performed the service ; 
he found that, after excision, he placed the wounded part in the 
mouth, previous to dusting on a drying powder. Examining the 
man carefully at once, he found that his mouth and throat were 
full of venereal sores, (mucous patches). Wendt 2 mentions cases 
of the same nature, stating that the operator is obliged, by a law 
in the Talmud, to suck the blood from the cut part. Albers 1 
refers to a case, under the care of Biett, of a Jewish boy who 
had been circumcised by a syphilitic Rabbi, and who became 
syphilitic thereby, beginning with an ulcer of the penis. Since 
this time, numerous cases have been observed in different localities 
by Taylor, 1 Kedotoff, and over a dozen others, and quite 
recently, Jaffe has considered the subject in reference to anti- 



180 SYPHILIS INSONTIUM 

septic surgery. He quotes Pitha in the statement, that, in Vienna 
thirty boys were infected in a short time by one operator ; and also 
mentions, that Vanier was once consulted by an old operator in 
this rite, on account of painful aphthae in the mouth, and that he 
saw also a boy, who had been recently operated on by this man, 
and who had been infected with syphilis from him. 

Hutchinson 23 has recently advanced the idea that in cases of 
ritual circumcision the infection was not always acquired from the 
mouth of the operator (psylle or mohel), but was conveyed by 
other means ; in a group of cases, which he investigated, he be- 
lieved that the poison was retained in some lint, which the operator 
carried in his surgical case, where he was accustomed to lay the 
excised prepuce, in order to take it home that it might be ceremo- 
niously buried ; this lint was afterwards used as an application to 
other circumcision wounds. The operator was found to be free 
from syphilis, and, moreover, he never sucked the penis to staunch 
the blood. It may be stated, that other observers have often failed 
to find syphilitic lesions in the mouth of the operator. On the other 
hand, as already detailed, many observers have seen the disease 
communicated in the manner described, and so well recognized 
was this manner of transmitting syphilis, that- it was the subject 
of judicial inquiry in France, and Ricord x was finally instrumental 
in having the practice of staunching the blood by the mouth 
abandoned in Paris. 

2. Buccal infection with apparently imbroken surface. Two quite 
different operations come under this category. 

i st. Breast-drawing; and, 

2nd. Removing foreign particles from the eye. 
' Each of these practices have, at times, given infection to a 
considerable number of persons. 

i. Breast-drawing, as a means of conveying syphilis, has been 
known for many years, indeed, some of the earliest epidemics of 
the disease were caused in this manner. Thus, Everardus, of 
Middelbourg, records an epidemic in Holland in 1654, where a 
professional breast-drawer infected many patients with chancres 
of the breast; these in turn infected their nurslings, and these 
communicated the disease to nurse-maids and servant-girls, from 
chewing pap, kissing, etc. The most recent epidemic of this 
nature, occurred in t88o, and is found recorded by Leloir. 7 A 

1 Ricord. Lettres sur la Syphilis. Phila., 1852, p. 114. 



SYPHILIS COMMUNICATED IN BREAST-DRAWING 



181 



woman, engaged in breast-drawing, received a chancre of the lower 
lip from one of her clients whose husband was syphilitic. Igno- 
rant of the importance of her complaint, which she attributed to 
a burn from a hot potato, she continued her calling without seeking 
medical advice, and infected successively many women whom 
she had attended. Certain of these cases came under the care of 
the physician who wrote the account to Leloir, which presented 
the following facts: The first woman acquired a chancre of the 
nipple (base of the left), her child became syphilitic, and her husband 
also acquired the disease, through the child's nursing-bottle. The 
second case was in a multipara, whose child died syphilitic: the 
third case was also that of a multipara, who had a most severe 
attack of syphilis, with early cerebral manifestations, and died 
about a year after acquiring the chancre. The fourth case was in 
a primipara, who acquired chancre of the breast, which she gave 
to her infant, who in turn infected its wet-nurse, and she her own 
child. These cases, arranged graphically, appear as follows : 



Syphilitic husband 
infects 

His wife 

she infects 

I 

Breast-drawer (chancre of lip) 

she infects 



Mad. A. (chancre of nipple) 
infects 

I 
Own infant 
infects 
I 
Father (from nursing-bottle). 



I 
Mad. B. 

(chancre of nipple) 

infects 

I 

Own infant 

(died). 



Mad. C. 
(chancre of nipple) 
(had early nervous 
syphilis and died, 
about a year later). 



I 
Mad. D. 

(chancre 
of nipple) 
infects 
I 
Own infant 
infects 

Wet-nurse 

infects 

I 

Own infant. 



Occasionally, the function of breast-drawing is performed by 
some other person than the professional, such as a member of the 
household, husband, friend or child, and cases are on record where 
syphilis has thus been disseminated. Durkee 3 reports an instance, 
under the care of Dr. Bigelow, of Boston, which is full of interest. 
A wet-nurse lost her child suddenly, and her breasts were dis- 
tended; to relieve them she engaged a female friend and her 
daughter, aged 14, to draw the milk by the mouth several times 



1 82 SYPHILIS INSONTIUM 

daily, and they both became syphilitic. Joly reports a case, where 
a syphilitic foundling infected a wet-nurse. Her own son, aged 10, 
then drew her breasts and became syphilitic ; several other women 
were also in need of aid, and the boy performed the same office 
for them, and several of them became infected from him : one of 
these women infected her own child, and her sister's infant from 
the sore on the breast, of the nature of which she was ignorant; 
her eldest daughter also became infected, by means of eating 
utensils used for the infant, and her husband acquired the disease 
from her. Put in tabular form, these cases stand thus : 

Syphilitic foundling- 
infects 

Foster-mother (chancre of breast) 
infects 

Own son, 10 years of age (by breast-drawing) 
infects 

Several women (by breast-drawing) 

one of them 

infects 

. I _____ 

Own nursling Sister's infant . Husband, 

infects " • (by nursing). 

Eldest sister (by spoon). 

Rollet 1 reports the case of a woman, aged 30, who took a 
nursling, who appeared healthy, but later died of hereditary 
syphilis ; she had an indurated ulcer of the nipple, with axillary 
and pectoral adenopathy, and her daughter 10 years old, became 
infected on the lip from drawing off the milk. 

A singular case is reported by Rupp, 3 where a child, six months 
old, was infected by its dry-nurse; the child then infected its 
nurse-mother, with sores on the nipple, so that nursing was dis- 
continued. The husband, to relieve the breasts tried to draw off 
the milk through the bowl of a clay pipe, and acquired syphilis, 
beginning in the throat. 

2. The application of the tongue to the eye for the purpose of remov- 
ing foreign particles, has on repeated occasions been the means of 
communicating syphilis, and on one occasion, at least, was the 
cause of a small epidemic. Tepljaschin, a government physician 
in Wjatha, reported, that in two small villages in Russia, having 
81 families with a total population of 532, he found 68 individuals 

1 Rollet. Recherchcs clin. et experim. sur la syphilis, etc., Paris, 1861, Obs. xviii. 



SYPHILIS COMMUNICATED BY TATTOOING 183 

infected with syphilis, 23 males and 45 females: about one-quarter 
of them were under 10 years of age. One -half the*entire number 
were infected by a female quack, who had followed the industry of 
removing foreign bodies, and treating trachoma, with the tongue. 
This practice is said to be still very common among the ignorant, 
Russian peasants, and to be employed in various eye diseases. 
This woman became infected in her calling, and pursued it with 
the results mentioned. 

Nearly a dozen writers have reported cases of syphilis trans- 
mitted by this same method, several of them occurring in this 
country ; two of these recorded by Montgomery, may be of special 
interest. A patient had spilled pepper into her eye, and a servant- 
girl, said to be badly diseased, had tried to remove it by sweeping 
the tongue over the conjunctiva; a chancre of the left upper lid 
resulted. The second case, was that of an hostler, who had a small 
foreign body in his eye, which a "chum" removed with his 
tongue : a chancre of the middle of the left upper lid resulted ; 
Andrews has recently reported a similar case occurring in this 
city. 

2. Infection by instrumental contact (the instrument being soiled 
by the operator's saliva). 

Tattooing and Cupping have been repeatedly reported as having 
conveyed syphilis, and in each of these operations the infection 
may occur in two manners : 

1 st. By a soiling of the instruments with the operator's saliva; 
and, 

2nd. By the transference of the poison from one subject to 
another. 

It will be seen that the second class of cases belong to the next 
main group, where the operator is the medium; but for convenience 
they will both be considered together here, for it is often very 
difficult to determine exactly as to whether the poison was 
furnished by the operator, or by another subject. 

1. Tattooing. As seen in Table III. of extra-genital chancres, in 
Chapter III., records have been found of 82 instances which have 
been reported, where syphilis has been conveyed by the process 
of tattooing, while a number of writers speak of the same in 
general terms, referring to "many cases.'/ Tardieu 1 states, that 
a soldier, with syphilitic lesions in the mouth communicated the 

1 Tardieu. Etude medico-legale sur les maladies p>rod. artificiellement, etc. Paris, 1879, p. 263. 



184 SYPHILIS INSONTIUM 

disease thus, to " a large number of his comrades." Rollet 1 
remarks that many military surgeons have cited cases of syphilis 
from tattooing, observed in Africa, where the practice is very 
common. In most of these cases, the syphilis has been derived 
from mucous patches in the mouth of the operator, through the 
practice of wetting the needles with saliva during the operation, 
or of using the saliva to moisten the pigment introduced : Geigel, 2 
however, in referring to certain cases reported by Poilroux, con- 
sidered that they were probably caused by the use of the same 
needles on both infected and healthy subjects, as will be seen to 
be the case, occasionally, in vaccination. 

The most complete and interesting account of syphilis commu- 
nicated by tattooing, is found in the careful and exhaustive report 
of Maury and Dulles, who give a minute detail of fifteen persons 
who acquired the disease in this manner from one operator. The 
man who had pursued the practice had been operating in many 
cities, and it is supposed that he inoculated a much larger number 
of individuals ; he was arrested in Philadelphia, and at the time of 
the report he was detained in the House of Correction; his mouth 
then presented active mucous lesions, which. had existed for six 
months or more, as the investigation showed from the records of 
institutions where he had been treated from time to time. 

2. Wet-cupping has, on a number of occasions, been the cause of 
epidemics of syphilis, sometimes of considerable extent ; this has 
happened mainly, of course, among the more ignorant, peasant 
communities of Europe, where the practice was often carried on 
by itinerant persons, or occasionally in bathing establishments. 
Tn many of these cases the virus was supplied by the operators, 
who wet the cups with their mouths ; in others the contagion was 
given from one person to another, by the scarifying instruments 
or cups. 

The celebrated Maladie de Brunn* in Moravia, in 1578, was of 
this nature, and during the space of two or three months 80 per- 
sons were attacked in the village, and nearly one hundred in the 
neighborhood, besides others in the surrounding country. Hjelt 1 
describes an epidemic occurring in the village of Hakola, in 
Finnland, in 1858, where almost 200 persons were infected, the 
operator being a woman suffering from syphilis ; he also mentions 

1 Rollet. Annales de Derm, et de Syph., I. (1S69), p. 403. 

2 See Rollet. Traite des Mai. verier., Paris, 1886, p. 459. 



SYPHILIS COMMUNICATED BY SKIN-GRAFTING 185 

several other smaller epidemics, amounting to over 100 more infec- 
tions, and quotes Dr. Graulund, as having seen many instances 
of the same. The latter writer believed that the virus was con- 
veyed by means of the cups, which were made of horn, and 
which so absorbed the poison that no cleansing could remove it; 
he, therefore, advocated using glass cups instead. 

We come now to speak of the third group of cases, in which the 
operator acts as the medium, conveying the virus on some instru- 
ment or object from one person to another. 

in. Operator the Medium of Syphilitic Infection. 

Here there are three general classes found : 

1 st. Where there is some intentional transference of solid or 
liquid substances, which are found to contain the poison ; 

2nd. Where unclean instruments act as the medium ; and, 

3d. Where unclean substances act as the medium. 

1. Infection by means of transplantation and inoculation. These 
may be either, 

1. Solid, organized substances ; or, 

2. Liquid substances. 

1 . Solid orga?iized substances, the medium of syphilitic infection. 
This includes, 

1. Transplantation of teeth; and, 

2. Skin grafting. 

1. Transplantation of teeth has been the means of conveying 
syphilis, as shown in the cases of Hunter, 5 W. Watson, and others; 
as this operation may yet occasionally be performed, as reported by 
Miller 1 and others, these observations are not without practical 
interest. 

2. Skin-grafting is reported by Deubel, as having caused the 
inoculation of syphilis : A man, 49 years old, had a large ulcerated 
surface, consequent upon gangrenous erysipelas, and upon this 
surface, forty-five epidermic grafts were inserted. Thirty-three 
of these took, and at a later period, forty-three more grafts were 
applied. The cicatrization proceeded rapidly for a while, when a 
small greyish spot appeared, an inch in diameter, and very shortly 
the whole surface became involved in a large ulcer; this remained 
open for three months, and at the end of this time, an erythema- 
tous eruption and other syphilitic phenomena appeared; the 

1 Miller. Implantation of human teeth : the limits of its success. Journ. Amer Med Assoc. X 
(1888), p. 354. 



i86 



SYPHILIS INSONTIUM 



original ulceration then healed under specific treatment. Just 
before the eruption appeared, the son of the patient, who had 
furnished some of the grafts, came under Dr. Deubel's treatment 
for ulcerations at the anus, which were found to be mucous 
patches. 

2. Liquid substances the medium of syphilitic infection. Under this 
head are included infection in the operations of, 

i. Vaccination; 

2. Variolation; and, 

3. Syphilization (so called). 

1. Vaccifial Syphilis. The subject of the conveyance of syphilis 
by vaccifiatio?i, is a very large one, and could alone fill many books, 
with the data which have been recorded in connection there- 
with. The memorable debate, in the French Academy of 
Medicine in 1865, 1 marked an epoch in the development of the 
subject, which is now well-recognized, and the principles connect- 
ed with it belong to the common knowledge of the profession. 
Heyd 2 has made a careful study of the matter, and gives a very 
full bibliography of the subject; also Kjerner, 3 Petit, 4 Freund, 6 
and Fournier 6 have written exhaustive essays upon the same. 
Freund gives a chronological list of authenticated cases up to the 
year 1880, with abstracts of the data; the cases foot up to about 
400, with a large number of additional infections from them ; he, 
however, does not refer to any episodes occurring in this country. 

As will be seen from Chapter VI. , vaccination has at times 
given rise to many epidemics of syphilis, almost more than those 
from any other single cause; the first of these occurred in 18 14, 
since which time groups of cases, from the same cause, have been 
reported almost to the date of writing ; during the late civil war in 
this country, syphilitic infection occurred in a large number of 
instances, estimated even as high as a thousand persons. A 
number of the episodes were - reported, and the actual cases 
mentioned amounted to nearly four hundred, as collected by 
Foster, 1 who has presented the subject very strongly. 

One of the largest, as well as the most perfectly reported single 



1 De la syphilis vaccinale, etc., Paris, 1865. 

3 Heyd. Zur Frage der Uebertrag. d. Syph. durch. d. Schutzpockenimpfung, Stuttgart, 1867. 

3 Kjerner. Ora Syphilis vac.cinalis, Stockholm, 1866. 

4 Petit. Transmission de la syphilis par la vaccination, Paris, 1867. 
e Freund. Zur Prophylaxe der Impfsyphilis, etc., Breslau, 1880. 

<> Fournier, Lemons sur la syphilis vaccinale, Paris, 1889 



SYPHILIS COMMUNICATED IN VACCINATION 187 

epidemic of vaccinal syphilis, is that recorded by Pacchiotti, 1 as 
taking place in the year 1861 ; this occurred in the town of Rival ta, 
in Italy, a village of about 2000 inhabitants, where 80 persons 
were syphilized, either directly or indirectly, through vaccination. 
The first vaccination was practised on a child named Chiabrera, 
eleven months old, with vaccine-matter in a tube from the public 
institute at Acqui ; the child was supposed to be perfectly healthy, 
but it was afterwards learned that he had been infected with 
syphilis, two or three months previously, by a woman whose 
breasts he had drawn, after the death of her own child. This 
same woman infected her sister's child, in the same manner, and 
she, in turn, infected her mother. 

From this first child, Chiabrera, on the 10th day, 46 healthy 
children were vaccinated, in 39 of whom syphilis developed. One 
of these children, by name Mauzone, served again as vaccinifer 
on the 10th day, and from him 17 infants were vaccinated; of 
these 7 acquired syphilis, and he also gave the disease to his wet- 
nurse, and himself died from it, within three months. From 
these 46 children, who were infected in these two series of vaccin- 
ations, 26 mothers and nurses received the disease, within eight 
months, together with 3 other children, who had not been 
vaccinated ; five of the women gave the disease to their husbands, 
it beginning with a chancre on the penis, a total of 80 up to 
the time of the report of the Commission; of the infected 
children 7 died. Put in tabular form, this epidemic stands thus : 

Liberata Pavone 
infects by suckling 



I I 

Chiabrera Sister's child 

infects infects (by suckling) 

i i Its mother. 



(by vaccination) (by vaccination) (by suckling) 

Mauzone 38 other children. t Own mother, 

infects (and dies) infect 



(by suckling) (by vaccination) 
Its wet-nurse. 7 other children, 
infect 

I 



Three brothers and sisters. (by suckling and otherwise) 

(not vaccinated) 26 mothers and nurses. 

infect 



I 



5 husbands 
(chancres of penis). 



i88 



SYPHILIS INSONTIUM 



Another very striking, though smaller epidemic, spread largely 
by vaccination, is that reported by Adelasio, 1 which occurred near 
Bergamo, in Northern Italy, in 1862. Six children were vaccinated 
from a child, GirolamaCarenini, who, although apparently healthy, 
had had a very mild eruption, which was afterwards regarded as 
syphilitic ; of these six vaccinees, five had syphilis, and from them 
six nursing- women acquired chancres on the nipple, and four other 
persons were infected in various ways. Four husbands were sub- 
sequently infected by their wives, besides three other children, from 
nursing; one of these again communicated syphilis to another 
nursing mother, a total of twenty-three persons from the original 
vaccinifer. In tabular form, these cases appeaf as follows : 



Girolama Carenini 
infected (by vaccination) 



C. L. (aged 5 mos.) 
infected 



D. M. (aged n mos.) M. M. (aged 8 mos.) R. L. (aged 2 mos.) 

infected 
I 



Mother, 
(chancre 
of nipple) 



Sister, 

(by 
spoon). 
(by suckling) 

C. L, (Aunt, 

chancre nipple) 

infected 



infected 
(by suckling) 

I 

Mother (chancre 

of nipple). 

infected 

I 
Husband 
(chancre penis). 



(by nursing) 
Own child. 



(by nursing) 

A. L., Nephew 

infected 

I 

(by suckling) 
J L., its mother. 



infected 

I 

(by suckling) 
Mother 
infected 

I 
Husband 
(chancre penis). 



J. V. (aged 
6 mos.) 
infected 



Mother Brother 
infected (aged 4 yrs.) 

I (by spoon). 

Husband. 



C. C, Nurse (chan- Mother 

ere of nipple) (chanc. nipple) 
and S. C, (her son) infected 
(from same dishes). | 



Her own infant 
(by nursing). 



Husband 

(chancre 

penis). 



Space forbids ou * entering fully upon the various points in 
connection with the transmission of syphilis by vaccination, which 
have, indeed, been fully discussed by many, and which find 
full elaboration in certain works on syphilis, notably that by 
Fournier, 60 on " Syphilis Vaccinale. " 

It may be remarked, however, that a study of the cases which 
have been carefully reported by many observers, shows that 
vaccino-syphilis differs in some respects from syphilis transmitted 
in other ways, and may, in a measure, throw light on the disease 
as it occurs endemically, under various forms and with different 
names. It appears to be somewhat influenced by the many elements 



SYPHILIS COMMUNICATED IN VACCINATION, ETC. 189 

of race, climate, and other causes, so that sometimes it has not 
been recognized until after long and patient study, in the light of 
later observations. In vaccino-syphilis the incubation of the 
disease is certainly hastened, so that, as appears also in the 
epidemics cited, the vesicle, even by the eighth day, can develop 
syphilitic virus sufficient to inoculate many others, and this again 
on the eighth day may repeat the process. Again, the syphilis 
may be so latent that the child may appear to be in blooming 
health and still serve as a syphilifer. 

2. Variolation. The operation of inoculating for variola, has 
been charged with conveying also syphilis, 1 but no authentic cases 
are accessible. 

3. Syphilization, in the strict sense of the word, namely, the 
inoculation of an individual free from syphilis, with the blood 
or morbid secretions from a syphilitic person, will almost, if not 
quite invariably, be followed by a development of the disease; 
it is this, of course, which takes place in every case of infection. 
Occasionally this has been done intentionally, as in the well- 
known experiments some years ago, in the study of syphilis, by 
Wallace, Waller, Pkllizzari, Bidenkap, and others. Occasion- 
ally the poison has been introduced accidentally in the so called 
process of syphilization, or the repeated inoculation with chan- 
croidal virus, which was advocated so strongly some years ago, 
by Sperino 2 and Boeck. 

An interesting case was reported by Danielssen, 3 where a leper 
had been inoculated with "virus of a soft chancre, to the extent 
of nearly four hundred inoculations, when the secretion of an 
indurated chancre was accidentally inserted. The inoculated point 
healed, but a month afterwards an indurated sore appeared, 
followed by unmistakable signs of secondary syphilis." 

2. Infection by means of unclean instruments. Under this cate- 
gory we find cases where infection took place : 

1st. By means of cutting instruments; and, 

2nd. By means of blunt instruments. 

1. Infection by means of cutting instruments. Two classes of cases 
may be found here, according as 1. The wound is accidental; and, 
2. The wound is intentional. 



1 De la syphilis vaccinale. Communications a l'Acad. de med., Paris, 1865, p. 209. 

2 Sperino. La Sifilizzazione studiata qual mezzo curativo, etc. Torino, 1853. 
8 Danielssen: cited by Lee. — Lectures on Syphilis, etc., Phila., 1875, p. 164. 



190 SYPHILIS INSONTIUM 

1. Infection by accidental professional wounds. The only instances 
which have been found of this description, are those relating to 
dentists' instruments, and those given by the razor in shaving. 

1. Dental instruments. In Chapter IV. an original case, No. 
XCIIL, is given, where a chancre of the right side of the tongue 
resulted from a wound by a dentist, the poison being almost cer- 
tainly furnished at the same time. 1 Leloir 15 mentions the case of 
a man with infecting chancre of the gum, in which the contagion 
seemed to have been produced by the process of preparing and 
filling a decayed tooth; Lancereaux 8 relates a case of chancre of 
the gum in a woman, after extraction of a tooth and other dental 
work, and Giovannini, 2 of Bologna, has reported a chancre of the 
lip apparently from a dentist's instrument; Otis 5 speaks of a case 
of a chancre just within the angle of the mouth, on the right side, 
appearing characteristically about three weeks after a morning 
spent in a dentist's chair; and Dulles 2 has reported the case of a 
"woman who was inoculated with syphilis of the most malignant 
type while under a dentist's hands." 

Roddick, 6 of Montreal, Canada, a most careful and competent 
observer, has recorded a very interesting case of chancre of the 
gum, resulting from infection by means of dental forceps, whereby 
the gum had been much lacerated, in the extraction of a tooth. 
The patient was the wife of a physician, aged about 30, and a 
careful study of every detail led to the conclusion that, "in all 
probability the instrument used by the dentist was made the 
vehicle of contagion, by being brought into contact with a mucous 
patch in the mouth of a syphilitic person, previously operated 
upon. " 

2. Razor wounds. While these have been frequently reported 
to be followed by the initial lesion of syphilis, no case has been 
found which proves that the infection occurs by means of the razor 
itself, indeed, it is most probable that such is never the case ; the 
frequent sharpening and cleansing of the razor would suffice to 
effectually remove any adhering virus. The inoculation possibly 
either takes place in the subsequent manipulations by the hands 
of the barber, from the towel, or from other means at the time, or, 
more frequently from a later introduction of the poison. In 
Chapter IV. will be found characteristic illustrations of infection 
received through this means (Cases XCV., XCVL, XCVII., 

1 Bulkley. — Dangers from Syphilis in Dentistry. Internat. Dental Jour., 1890. 






IXFECTION IN MINOR SURGICAL OPERATIONS 191 

XCVIIL). Nearly fifty different observers have reported cases of 
this kind, the first, perhaps, was that of Vallauri, in 1836. La- 
doire-Yver reports the case of an officer, in whom the barber of 
the regiment, in order to check hemorrhage from a razor-cut, 
pressed firmly on it with his thumb, and a chancre developed on 
the cheek in the site of the cut; " when examined, the barber pre- 
sented a chancre of the same kind as the victim." 

In many or most of these cases, the shaving was done at a 
public establishment. Allen 2 has recently mentioned a case, 
where a man cut himself while shaving with a razor borrowed 
from a friend, and in the site of the cut a chancre developed ; the 
friend had an eruption on the face and body, and was said to be 
suffering from syphilis, but there was no confrontation. 

2. Infection by intentional professional wounds (phlebotomy, minor 
surgery, wet-cupping, tattooing, vaccination, etc.). 

1. Phlebotomy. In view of the great frequency of bleeding in 
former times, and the recklessness with which it was done, often 
in large numbers together and in succession, it would not be at all 
strange if syphilis were .often conveyed to the wound. We find, 
however, but little reference to the subject. Bonorden mentions 
having seen a case, where a large chancre developed in a wound 
made by a lancet; an instance is quoted from Adam a Lebenwald, 
where five healthy persons were bled with a lancet, which had 
been recently used on a syphilitic, and all five were infected; there 
is some doubt, however, in regard to the infection here, as it is 
stated that all the five died, which could hardly be expected from 
syphilitic infection. 

2. Minor surgical operations, have sometimes been followed by 
syphilitic infection. Lang 1 reported a case, where a gentleman, 
aged about 40, had a furuncle on the forehead which was incised ; 
instead of healing, a chancre formed, followed by constitutional 
symptoms; Kobner 10 mentions a case, where the opening of an 
axillary abscess was followed by a chancre, and another, where 
the operation of scarifying the scrotum, for " gonorrhceal hydro- 
cele," was succeeded by an indurated chancre, with constitutional 
syphilis. Robinson ! relates the case of a boy, six years of age, 
of healthy parents, who was circumcised for congenital phymosis, 
and who developed thereon an ulcerating lesion, followed by a 
mucous patch on the tongue, and a rose-colored rash. Homolle 
states that the incision of a furuncle on the buttocks, and the 



192 SYPHILIS INSONTIUM 

excision of vegetations, have both given occasion for the entrance 
of syphilitic poison. Moes has reported a chancre of the eyelid 
following the incision of a stye. 

i. Wet-cupping, tattooing and vaccination, have been already 
treated of, and need not be again considered ; they are mentioned 
here in connection with instruments, as the virus has been some- 
times conveyed in this manner. 

2. Infection by means of blunt instruments (Eustachian-catheters, 
surgical sounds and specula, serres-fines, porte-caustiques, syringes, 
and other apparatus). 

i . Eustachian catheterization. One of the most interesting and 
deplorable instances of the communication of syphilis profession- 
ally, is by this now well-known method of infection. The first 
published case was by E. Fournie, in 1862, and Ricord, who was 
called in consultation, stated, that he had seen four similar cases 
previously. Since this date, nearly forty observers have reported 
cases, amounting in all to more than 100 victims; of these over 60 
were said to have been traced to the practice of a celebrated ear 
specialist, Dr. B., in Paris, now dead. Others have been reported 
in Germany, Austria, Russia, and in this country, as seen in the 
Synopsis of Literature, and Bibliography. 

The method of infection in these cases is easy to understand; 
the insertion of the sound, or catheter, into the throat of one 
person after another, without proper cleansing, can most readily 
convey the poison from the freely secreting mucous membrane of 
an occasional syphilitic patient, to the readily abraded mucous mem- 
brane of a healthy subject. From the description given of the 
lesions of the throat, in many of these cases, (there often being a 
vast ulcer, occupying much of the vault of the pharynx), some- 
thing may be learned, regarding the earlier epidemic and endemic 
extensions of syphilis, such as Sibbens and some of the Syphiloids 
occurring along the Baltic Sea, and other places, where much 
stress is laid upon the throat lesions. The descriptions given of 
some of these Eustachian cases, resemble very greatly those of 
the affections referred to, in that they exhibit unusual severity 
and precocity, with absolute loss of any distinction between 
primary, secondary, and tertiary lesions; in some cases there 
occurred periostitis, destructive ulcerations and perforations, 
almost from the start. The primary lesion in these cases, is 
generally seated on the posterior pillar of the fauces, or on the 



INFECTION BY CAUSTIC HOLDERS, ETC. 193 

upper surface of the soft palate, or, on the posterior wall of the 
pharynx, near the fossa of Rosenmuller, or finally, at the edge of 
the Eustachian tube. 1 

1. Surgical sounds and specula, are accredited by many with hav- 
ing been the means of transmitting syphilis, but no definite state- 
ments, or cases illustrative of this, can be found; Tardieu, 8 
however, alludes to "a most regretable case, which made a great 
stir, where syphilis was transmitted by means of a speculum." 
The same author mentions a case where a young man, who had 
never had sexual intercourse, was inoculated with syphilis by means 
of serres fines, which were used after an operation for phymosis. 

2. Caustic holders, etc. Leloir 16 narrates a case, where the syph- 
ilitic poison was supposed to be transferred, by means of nitrate of 
silver, which had been previously used to touch buccal lesions ; a 
chancre developed upon a slight burn which was touched with the 
same. I have been told by a physician that he believed, that he 
had communicated the disease in this same manner; he remarked, 
however, correctly as I believe, that the disease was probably not 
conveyed by the caustic itself, but by the holder ; the piece of 
nitrate of silver was very short, and he supposed that the holder 
touched the parts and conveyed the poison. Taylor 20 has recently 
recorded a similar case. C. Pellizzari 20 reports a case where a 
chancre, on the leg of a child with infantile paralysis, w T as 
produced by the employment of an electric brush ; the lesion was at 
first thought to be tropho-neurotic, but the later phenomena proved 
it to be the primary sore of syphilis. The transmission of syphilis 
by means of syringes, has been already considered, under domestic 
syphilis, in Chapter VII. 

3. Infection by means of unclean substances. A case is reported 
by Moty, where a man acquired a chancre on the left upper eyelid, 
which was attributed to using the same wash-water which had been 
used by venereal patients; the man had conjunctivitis, and dipped 
the cloths used to moisten his eyes in the water. Another instance 
of supposed infection by wash-water is mentioned in the previous 
chapter, under brephotrophic syphilis. Mention has already been 
made of the fact, that in certain cases of circumcision-syphilis 
Hutchinson concluded that the poison had been conveyed by 
means of the lint, soaked in the blood of the prepuce, which had 
been removed. 



1 Baratoux. De la Syph. de l'oreille. Paris, 1886, p. 77. 
14 



194 SYPHILIS INSONTIUM 

Pellizzari 25 records a case where infection took place in a. 
remarkable manner. A woman, who had been syphilitic but a few 
months, but cured of any active manifestations of the disease, 
was operated on for piles. The overseer of the infirmary, 
a man aged 65, held the fragments of tissue removed in a rag, 
collecting and holding them during the operation, his whole right 
hand becoming covered with blood. Some time afterward, a 
small wound was noticed between the nail and the pulp of the 
right index finger; this was not recognized at first, but soon 
became a deep and livid sore, with axillary engorgement, and was 
followed by constitutional syphilis, and four years later he had 
hemiplegia. 

Profeta 7 published an observation which is considered very 
probable by Jullien, where a chancre was situated in an inter- 
digital space of the right hand, and which the most minute 
research seemed to point to an acarus scabiei as the mode of con- 
veying the syphilitic contagion. Diday is quoted as having been 
the first to call attention to this method of transmission of syphilis 
by parasites. In view, however, of more recent cases reported by 
du Castel, 1 Fournier, 67 Feulard, 2 Lallier,- 2 and Pollaesik, of 
chancres occurring on the arms and elsewhere in patients who were 
under treatment for scabies, it would seem more probable that the 
poison gained entrance during the manipulations, from uncleanli- 
ness, rather than from the conveyance of the virus by the insect : at 
any rate this illustrates and explains the very frequent occurrence 
of scabies and syphilis in some of the epidemics and endemics of 
syphilitic infection, where, from the descriptions given, scabies 
appears certainly to have been present. 

We have seen in this chapter that syphilis may be acquired by 
the person rendering a professional service ; further, that the dis- 
ease may be communicated from the operator to others ; we have 
also seen that the operator may only act as the agent, transferring 
the disease from one person to another by means of his own per- 
son, or by instruments or objects bearing the virus. 

Undoubtedly further research would disclose a yet greater 
variety in the forms and methods of infection than has been 
presented in these pages, and in the accompanying Synopsis and 
Analytical Bibliography, and unquestionably further experience 
will add new data with each successive year. 



SYPHILIS IN THE INNOCENT 1 95 

No amount of human wisdom could possibly have foreknown, 
or even have suspected, many of the facts which have been 
detailed in this and preceding chapters, nor could any reasonable 
amount of care have prevented many of the sad events here 
recounted. The syphilitic poison is an agent whose effects are 
known only after the damage has occurred, and thus, prophylaxis 
becomes of the utmost importance, greater, if possible, than in 
reference to any other disease known to man. 

A short consideration of the means of controlling the unneces- 
sary spread of a disease which can cause such damage to innocents, 
would, therefore, seem appropriate in this connection. 



CHAPTER X. 

prophylaxis: hygiene and medico-legal CONSIDERATIONS. PLAN 

FOR THE LEGAL CONTROL OF SYPHILIS. 

From what has preceded it may readily be understood that 
syphilis is a disease which inflicts great injury upon the public 
health; for it imperils not only those who have been guilty of 
sexual transgressions, but also those who are quite innocent. 

While an exaggerated idea of its perils might be obtained 
from the material presented in the preceding chapters, it is 
impossible to shut our eyes to the fact that it presents a real 
and considerable danger to the innocent," as is evidenced by the 
thousands of cases referred to in this book. No amount of 
reasoning or argument can do away with the facts which I have 
cited from the highest medical authorities, and from my own 
recorded cases. Not only does this infection occur in the daily 
intercourse and occupations of life, but also in the most varied 
relations, in the care of children, in industrial pursuits, and in 
professional callings. 

Our considerations, therefore, in regard to its prophylaxis, 
including the legal control of the disease, will be largely based 
upon the dangers relating to its innocent transmission and the 
necessity of arresting the progress of a malady which is capable of 
doing so much harm. 

Although the present work has to do mainly with syphilis 
insontium as acquired by extra-genital infection, it may be well to 
consider very briefly two other aspects from which a legal control 
of the disease is demanded : these relate to marital syphilis and 
hereditary syphilis. 

The subject of marital syphilis has been very fully discussed by 
a number of writers, and all acquainted with the subject know well 



MEDICO-LEGAL CONSIDERATIONS 197 

that this mode of infection stands prominent in connection with the 
innocent acquiring of the disease. While men occasionally con- 
tract syphilis in lawful wedlock, even, indeed, from wives who 
have acquired it in nursing or in some other innocent manner, it is 
principally the wives who suffer from the sins of their husbands, 
before or after marriage, and on them falls a large share of the 
burden of " innocent syphilis. " 

Reference has already been made to the studies of Fournier, 
who came to the conclusion that fully 25 per cent, of all females 
affected with syphilis acquired it honestly, in lawful marriage 
relations: also that Ricord thought that this proportion was 
too low. Among the married females in Fournier's private 
practice, in 75 per cent, the disease was unmistakably traced to 
the husband. I stated also that in my own private practice fully 
50 per cent, of the females with syphilis, acquired it in a perfectly 
innocent manner, while among the married females the percentage 
would be 85, or more. 

Surely then there is reason in the plea that something should 
be done to prevent the wholesale infection of these innocent 
victims of marital syphilis. But if this aspect of the subject 
seems dark, that of hereditary syphilis is yet darker, and calls 
even more strongly for relief. 

The literature of hereditary syphilis is very large and the facts 
related thereto are well known and accepted by all ; the pages of 
this book contain references indicating abundantly both the 
hereditary aspect of the disease and the dangers arising from 
contact with the child inheriting syphilis. 

We may for a moment refer to the effect of the poison upon 
the viability of children born of syphilitic parents. I cannot do 
better than to refer to some very striking tables given by Sturgis 
in an appendix to Diday's work on infantile syphilis 1 ; they are 
from the records of births of syphilitic children at the Moscow 
Hospital, Russia, from i860 to 1870. During these years there 
were 2,002 births, and 1,425 deaths, or, 71 per cent, of the children 
born there of syphilitic parents died. Kassowitz 2 gives the per- 
centage of still-births of syphilitic parents at 33.6, and that of 
infants dying within six months at 24.3; these two make almost 
58 per cent, dead born, or dying within six months after birth. 

1 Diday. Syphilis in New-born Children, etc. New York, 1883, p. 265. 

2 Kassowitz. Die Vererbung der Syphilis, Wicn, 1876, p. 122. 



198 SYPHILIS INSONTIUM 

It is to be remembered also, that just as syphilis can diminish 
the viability of the product of conception, and cause the death of 
the child, just before or soon after birth, so it causes loss of life 
earlier in conception, giving rise to abortion, even in the very 
earliest periods of utero-gestation ; in the same manner, going 
further back in the life-history of procreation, it is also a not 
infrequent cause of sterility, both in the male and in the female. 

If, therefore, the effects of syphilis were limited solely to a 
destruction of life in the new-born, or in the products of concep- 
tion, there would be strong reason for the introduction of measures 
to check the spread of the disease, from its loss to the 
State. 

But this is only a portion of the ills wrought by syphilis in 
connection with generation, and it would be better that children 
of syphilitic parents should thus fail of life, rather than be born 
with an inheritance which often proves such a curse. 

Tarnowsky x has recently, in writing on the subject, given us 
many interesting facts, among which the following may be men- 
tioned. In three families, born of syphilitic parents, there was a 
total of twenty- two births : of all these there came only one healthy 
adult man. Of thirteen who survived some years, eight were inca- 
pable of self-support, from mental or physical defects, and the 
other five were weakly, nervous, and totally unfit for further procre- 
ation. He states that the families in which this occurred belonged 
to the intelligent class of society, with no other cause than 
syphilis for these disastrous results. He quotes further from 
Tschistjakow 2 the case of a man who had severe syphilis in early 
life, destroying the palate, of whose nine children two were 
idiots, one was deaf and dumb, and one died in infancy. The 
works of Hutchinson and many others give abundant testimony 
as to the direful effects of syphilis on the progeny of those thus 
affected. 

Thus the army of innocents swells in size and pleads for the 
restriction of a disease, which, it is now believed, may sometimes 
be inherited even to the third generation. What the later 
effects of syphilis may be, in producing some of the conditions 
commonly known as scrofula, and in inducing race-degeneration, 
cannot now be answered positively; we know, however, that it 

1 Tarnowsky. Prostitution und Abolitionismus. Hamburg und Leipzig, 1890, p. 164. 

2 Tschistjakow. Ueber die Syphilis in der bauerlichen Bevolkerung. St. Petersburg, 1884, p. 55. 



PREVALENCE OF SYPHILIS IN THIS COUNTRY 199 

has at times decimated our Indian tribes, and has wrought un- 
speakable havoc in Russia, in the Hawaiian Islands and elsewhere. 

The individual with syphilis, therefore, is not only in danger 
of communicating the disease in marital relations, and constantly 
does so, but is also likely to transmit more or less of the taint 
to the offspring, if they survive. He is likewise a constant 
menace to society, by virtue of the contagious character of the 
disease, in some of its manifestations, even for a long time, as 
has abundantly appeared in the preceding chapters. 

It is quite true that the dangers of infection from syphilis and 
of its hereditary transmission, are greatly diminished by careful 
and proper care and treatment; but every one who has had much 
to do with the disease in hospital and dispensary practice knows 
how commonly it is neglected as soon as there cease to be annoy- 
ing symptoms. There are continually hundreds of syphilitics 
with contagious lesions, who are either ignorant or careless of the 
dangers to which they are subjecting others in their daily lives; 
and this is even seen in private practice. Innocent extra-genital 
infection is much more common than is generally supposed. 
Physicians are constantly meeting with cases of syphilis where 
the origin of the disease is a mystery; as the facts relating to 
innocent infection come to be more generally recognized, the 
mystery attending many cases will pass away. 

It has been already shown, in preceding chapters, that syphilis 
is now very widely diffused. It is undoubtedly on the increase, 
owing to the utter lack of sanitary control over it in the 
greater part of the world. There are no data obtainable to show 
its relative prevalence in different countries, except those relating 
to the armies of various nations, some of which have been already 
referred to. In many instances even these returns are not avail- 
able, inasmuch as they frequently report "venereal diseases" 
in general, and not syphilis distinctively. 

In this country, as I learn from the Surgeon-General's office, 
no reliable information exists in regard to the prevalence of 
syphilis : our army even furnishes no data. According to 
Sturgis 1 , however, there were in the army, in the Department of 
the East, in the five years from 1870- 18 74, 1488 cases of syphilis, 
or 4.22 cases per 100 men : in the mercantile marine of the 
United States, during 1872 and 1873, there were 3,779 cases of 

1 Sturgis. Relations of Syphilis to the Public Health. Trans. Amen .Med. Ass'n., 1877. 



200 SYPHILIS INSONTIUM 

syphilis, or 15.33 per cent, of all sailors treated in the hospitals : 
while in the city of New York, 16.19 P er cent, of all cases of 
sickness in the mercantile marine service were syphilitic. From 
the data furnished by the books of a number of dispensaries and 
hospitals in New York city during the year 1873, Dr. Sturgis 
estimates that the number of patients treated for syphilis during 
that year cannot be far from 50,000. 

Some idea of the frequence of syphilis in this country may be 
learned from the statistics collected by the American Dermato- 
logical Association, from different cities in the United States during 
the past fourteen years. Fully one tenth of the cases reported 
were those of syphilis, it coming next to eczema in frequency. 
In some respects this presents, perhaps, one of the best means 
from which to judge of its comparative prevalence; for, as syphilis 
rarely fails to manifest itself on the skin at some period during 
its course, cases of this disease are more likely to be observed 
and studied in dermatological practice than in other departments 
of medicine. These data were collected from private and 
public dermatological practice, and not from venereal clinics. - 

Syphilis is a disease worthy of the most serious thought and 
consideration by the physician and sanitarian. ' It stands second 
to none in pathological importance. The fact that in so large 
a share of cases it happens to be communicated through sexual 
contact, and in so great a proportion of these it is from unchaste 
venereal relations, by no means warrants its relegation wholly 
to a class of affections the very mention of which is to be 
tabooed in good society. 

In regard to the means of prophylaxis against syphilis, these 
relate, first : To the protection of the individual ; and, second, 
To public measures, or the legal control of syphilis. 

I. INDIVIDUAL PROPHYLAXIS 

Individual safety will result from a better and more 
widespread knowledge, on the part of the profession and the 
laity, of the manifestations of syphilis, its dangers, and the 
modes b} r which the disease has been transmitted. 

In the history of all epidemics of this disease, large and 
small, it is constantly stated that the true nature of the difficulty 
was not recognized, or that the dangers of infection were not 
known or appreciated until large numbers were affected. As 



PROPHYLAXIS OF SYPHILIS 201 

our knowledge of syphilis widens, and as the synthetic history 
of the disease is formed, so much less will be the danger of its 
communication by innocent means. 

A glance at the clinical history of syphilis insontium, as given 
in the preceding pages, shows this very conclusively. Thus, 
the dangers of its communication by vaccination were never 
thought of until a considerable number of cases of vaccinal 
syphilis had been reported; and undoubtedly multitudes of other 
cases had occurred which were never known. The possibility 
of inoculation by means of Eustachian catheterization was not 
suspected, until a considerable number of cases of syphilis from 
this cause were traced to the practice of one physician in Paris. 
Ritual circumcision had been practiced for thousands of years 
before it was demonstrated that syphilis could be communicated 
in the operation; and so on. 

Now, however, that the many dangers are more or less 
widely recognized, we no longer have so many of these 
lamentable events to record as are found in earlier years. 
Infection by lactation and by other recognized accidents is yearly 
becoming less frequent, and in most countries such general out- 
breaks of syphilis as the Maladies de Brunn, de St. Euphemie, de 
Chavanne-Lure, the Pian de Nerac, and many others which have 
been mentioned, are now well nigh impossible. 

Yet if we should conclude that innocent syphilis is really 
becoming less frequent of late years, we should make a serious 
mistake. Such is not the fact. In Chapter IV., of this essay 
I have recorded over one hundred original cases of extra-genital 
infection ; and these do not include the scores or rather hundreds 
of cases of innocent infantile and marital syphilis that I have 
seen. The same may also be learned from the multitudes of 
recent cases of syphilis spo?-adica, or scattered and isolated instances 
of innocent syphilis, detailed or alluded to in other chapters, and 
in the Synopsis and Bibliography. 

The ground, therefore, upon which personal safety from syphilis 
must rest, has yet to be reached; for, while the disease is allowed 
to spread freely by venereal contact, so long will cases of syphilis 
insontium continue to abound. This is evidenced by the innumer- 
able instances where the disease has been acquired, both in neces- 
sary and unnecessary contact with those thus diseased. A single 
instance of this may be recalled from the first portion of 



202 SYPHILIS INSONTIUM 

the preceding chapter. In this instance a syphilitic man infected 
his wife, she infected the breast-drawer; through her ten others 
"became infected, and several of them died from syphilis. How 
much farther the disease spread was not recorded, but it is very 
certain that it could not have ended there. Many, yes hundreds 
or thousands of instances could be found where one guilty 
member of a family has introduced syphilis into the home, and 
where there have been numbers of innocent victims; these 
have been both among those belonging to the family and those 
having social or industrial relations with them. 

II. LEGAL CONTROL OF SYPHILIS 

While syphilis commonly occurs as a " venereal" disease, its 
prophylaxis, or legal restraint, by no means relates entirely to the 
restriction of venereal diseases; the limitation of the spread of 
syphilis should be considered from a much broader and higher 
standpoint, namely, from that of defending the public health and 
that of individuals against a malady which affects the innocent 
and guilty alike, and which comes not only when its dangers are 
anticipated, but also when they are the least suspected. 

In the matter of legal protection against syphilis, therefore, 
the subject of prostitution becomes a secondary considera- 
tion. The first question is not one of "regulating prostitution," 
or of inspecting, licensing, or legalizing the "social evil, or of 
protecting those engaged in it. The legal control of syphilis has 
a much higher aim, namely, the prevention of the unnecessary 
extension of a disease which produces a vast amount of sickness, 
misery and death, not only among the guilty, but also among the 
perfectly innocent. 

That the spread of syphilis can be checked is self-evident, as 
has been conclusively proven by the fact that all the epidemics, 
large and small, which have been mentioned above, were arrested 
when the cause was recognized, and sufficient measures introduced 
to prevent the further transference of the poison from one person 
to another. It is also abundantly shown in those instances where 
foreign governments, in certain cities or localities, have enforced 
stringent measures looking in this direction. 

We know positively that the virus does not develop de novo, but 
that it is always communicated from one individual to another. We 
know also that within a certain period the disease ceases to be 



LEGAL CONTROL OF SYPHLLLS 203 

contagious in each individual; so that, if no new infection is intro- 
duced into a community, and the members of that community are 
guarded against acquiring the disease from one already infected, 
until that safe period is reached, the malady will cease to 
exist. 

Such precautions are exercised both by the public and by indi- 
viduals against other contagious diseases, such as small-pox, 
scarlatina, measles, diphtheria, yellow-fever, etc. ; is it not emi- 
nently proper that syphilis should be placed in the same category, 
and protection should be afforded against it? Syphilis counts its 
victims by thousands, where other diseases count hundreds. 
More deaths are ultimately caused by syphilis than by small-pox, 
while the injury to health and interference with life-work is 
much greater in the former than in the latter. The conclusion 
is absolute; syphilis should be placed, like other contagious 
diseases, under the control of the health authorities. 

Literature is full of matter relating to the medico-legal aspect 
of venereal diseases, and of syphilis in particular, and even a brief 
abstract of the subject would occupy much more space than can 
be given here; while a transcription of the laws and enact- 
ments bearing thereon, in other countries, would fill volumes. 
The subject of the legal control of syphilis is indeed a most difficult 
one to handle, and one which has occupied the attention of many 
able physicians and jurists. It has been studied especially in 
France, Belgium, and Germany, and it is in these countries that 
the most effort has been made by the governments to stay the 
progress of the disease. 

In Paris there is a certain police inspection of public women, 
and statistics show 1 that from 1877 to 1881, between 800 and 
1,200 women were each year sent to the prison-hospital of St. 
Lazare with syphilis. The number of individuals who might 
be infected from these syphilitics can hardly be computed. In 
many cities in Europe 2 there is exercised a certain control over 
public women infected with syphilis, and a varying amount of 
protection from the disease is afforded. 

In England, as is well known, a reaction took place against 
the "Contagious Diseases prevention acts," and they were finally 

1 Vibert. Nouveau Diet, de Med. et de Chirury. prat., Vol. 34, 1893, p. 916. 

8 Parent-Duchatelet. De la Prostitution clans la Ville de Paris, 1857. VoL II , p. 195 i Mireun 
7-a Syphilis et la Prostitution, etc. Paris, 1875 ; Reuss. La Prostitution au point de vue de l'hygiene, 
etc. Paris, 1889. 



204 SYPHILIS INSONTIUM 

repealed, in 1886, as already mentioned; and no effort is now made 
there, I believe, to control the development of syphilis. 

In this country, as far as is known, there are no sanitary safe- 
guards against the spread of syphilis, and there are very few 
hospital advantages for those thus affected. While in most cities 
in Europe there are large accommodations for this class of cases, 
amounting in Paris to between one and two thousand beds, New 
York has but a relatively small service at the City Hospital, while 
the vast majority of syphilitic patients are treated at the dispensa- 
ries, and are allowed to go about, often with lesions of a most 
dangerously infective character. It would be difficult to convey 
any idea of the carelessness and indifference of some of these 
patients when informed of the dangers attending their disease. 
Many, indeed the far larger share of them, disappear from treat- 
ment long before their syphilis is cured ; and generally, even, long 
before they have ceased to have lesions which may convey the 
disease to others. 

The amount of damage a .single unrestricted syphilitic patient 
may do, can be judged from a recent statement by Tarnowsky, 1 
of St. Petersburg. He says that a syphilitic woman, who had 
come under his observation, had succeeded in contaminating with 
syphilis no less than 300 men, within a period of ten months. This 
represents merely the primary transmission of the disease; its later 
effects on others can hardly be computed. Imagine one small-pox 
patient being allowed to give the disease freely to three hundred 
individuals ! 

The republican ideas of this country would probably never 
endorse or submit to such sanitary police inspection and restraint 
as is exercised in certain European cities; but the question 
naturally arises, if there is not some way in which the end can be 
reached, of arresting the spread of this dangerous disease ? Can 
there be no safeguards thrown out which shall prevent its exten- 
sion here, as it has spread in certain countries in Europe, notably 
Russia, where, as we have seen, whole communities have been 
syphilized, and Portugal, where the disease is almost universal ? 

The first step toward accomplishing the legal control of syphilis 
would undoubtedly be found in placing it among other contagious 
diseases which come under the jurisdiction of the health officers; 
legitimate means could then be devised and executed to check its 

1 Tarnowsky. — Cited in N. Y. Med. Record, Mar. q, 1889, p. 279. 



LEGAL CONTROL OF SYPHLLIS 205 

spread, as in the case of the contagious diseases ordinarily 
recognized. The late J. Marion Sims alluded to this subject, in 
his address before the American Medical Association 1 , some years 
ago, using these words: "There can be no difference of opinion 
among us, regarding the two following propositions. 1st. We 
want a system of sanitary inspection and control, which will 
enable us to prevent the importation of syphilis from abroad. 
2d. We want a system of sanitary inspection and control, which 
will enable us to take charge of the subjects of syphilis at home, 
and prevent them from spreading it through the community." 

The profession is undoubtedly unanimous, in regard to the 
desirability of having such a restraining influence exercised upon 
syphilis, as is here indicated. The only question is — what is the 
best method of carrying it into effect ? 

If syphilis were first recognized as one of the great contagious 
diseases, against which it is the duty of the government to protect 
the community, the details of that protection would follow with 
time ; and as the public became aware of the dangers arising from 
the disease, and the benefits accruing from its restriction, there 
would be no difficulty in securing proper laws relating to the subject. 

It would be out of place here to present any detailed plan of 
operation, for the subject is of such vast importance, that it could 
not be compassed within the limits of this essay, even if the writer 
were prepared to formulate such a scheme. 

The suggestion, however, is most earnestly put forward, that 
the time has certainly come, when the dangers of syphilis, and 
especially the dangers to innocent persons, should be fully 
recognized. It is too late in the history of science and of 
humanity to stigmatize the disease as "venereal," and on that 
account to withhold scientific protection from thousands of 
innocent sufferers. Among babies, nursing women, persons 
infected in dental or surgical operations, and in dozens of other 
manners, syphilis can no more be described as a "venereal" 
affection than any other contagious disease. The time has come 
to place it under the control of the proper health officers, and to 
make it quite as criminal to tra?ismit syphilis willingly as it is to 
communicate small-pox, scarlatina, or diphtheria. 

It would then become the public duty of each one to guard 
against the disease, and, as now in the case of the other contagious 

1 Sims. Trans. Amer. Med. Assoc, 1876. 



206 SYPHILIS INSONTIUM 

diseases mentioned, those would be culpable who were the means 
of disseminating the same. The hotel proprietor who wittingly 
allows a small-pox patient to infect others, or who should not 
exercise due precautions after a patient with scarlet fever had 
occupied a bed or room, would receive punishment. The keeper 
of a brothel, as I understand the existing law, would be subject 
to like punishment, if his guest were allowed to sleep in a bed 
previously occupied by a patient afflicted with small-pox, scarlatina, 
or diphtheria, without subsequent sanitary precautions. 

If, now, syphilis were included with these infectious or 
contagious diseases, something would certainly be accomplished 
toward checking its extension ; for such a person would then see 
that all the inmates of the house were free from syphilis, and 
would also be very careful that no one entering the place should 
introduce the disease. If the males did not carry syphilis into 
houses of ill-repute, the disease would not appear in them. 

The plan of making it criminal, or a misdemeanor, to be 
instrumental in communicating syphilis, would operate favorably 
in many ways. 

It would do away with the necessity of officially examin- 
ing, inspecting, or licensing any one, for it would be for 
each one's interest to keep free from the disease, lest at any time 
legal action should be taken against them. Instead of examining 
the women publicly, those connected with the nefarious business 
would see that they were already in a healthy condition. They 
would then examine the men. 

This again would operate advantageously. For many would 
hesiiate against going to houses of ill fame, if they knew that 
they were to be thus examined: and those that were syphilitic 
would exclude themselves. 

Furthermore, this would operate more or less against 
clandestine prostitution. For not only would every one fear lest 
they should acquire the disease (because it would be known that 
outside women would be more likely to be syphilitic), but the men 
would fear that, if they infected others outside, they would be 
subject to legal penalties. 

I believe, therefore, that such a law would not only greatly 
diminish the frequency of syphilis, but would also be in the 
direct line of breaking up licentiousness When the step is once 
taken of placing syphilis among the contagious diseases, subject 



LEGAL CONTROL OF SYPHILIS 207 

to law, the details necessary to enforce such a law will natur- 
ally follow. The force of the argument rests on the necessity 
of examining the men instead of the women ; for any proposition 
looking - to the latter has always met with resistance at the hands 
of many classes in every community, who urge the degrading 
character of police inspection. 

That a person may legally be held liable for communicating 
syphilis is abundantly shown by the many cases occurring in the lit- 
erature of foreign countries. The works of Tardieu, 1 Fournier, 2 
and others are full of accounts of legal action taken, and fines and 
imprisonment imposed, for the willful or careless transmission of 
syphilis ; and in some instances the actions were against physicians 
who had exercised every possible precaution. In our own country 
syphilis has sometimes been the subject of judicial action; in a 
recent case before the Court of Appeals, of Kentucky, 3 it was 
decided that syphilis pleaded in answer to an action to recover 
damages for breach of promise of marriage, is a complete defence ; 
this followed the decision of the Supreme Court of North Caro- 
lina, in which the same defence was interposed and sustained in a 
similar action. 

One of my own patients recently received five thousand dollars 
from the man who infected her with syphilis ; in this instance the 
case did not come to court, though it was settled through legal 
counsel. 

How far the matter can be carried in regard to the restraint 
of syphilitics from exposing others, cannot now be decided. 
Much enlightenment of the community is yet necessary in 
regard to this subject, and much thought will be requisite to deter- 
mine exactly the best methods of checking the slow but steady 
extension of syphilis which is now taking place. These matters can 
safely be left to future consideration. The first step is now to be 
taken by the legal recognition of syphilis as one of the contagious 
diseases which are dangerous to the life and health of the nation 
— as a pest against which society has the same right as in the case 
of other contagious diseases, namely, to protect itself by scientific 
treatment and by legal penalties. 

1 Tardieu. Etude Medico-legale, etc., Paris, 1879. 

2 Fournier. Nourrices et nourrisons syphilitiques, Paris, 1878. 

3 Journ. of the Amer. Med. Assoc, Oct. 8, 1892, p, 445. 



SYNOPSIS OF FACTS AND LITERATURE* 

RELATING TO 

SYPHILIS INSONTIUM 

ARRANGED IN ACCORDANCE WITH THE 

CLASSIFICATION OF MODES OF INFECTION 

(Sg* Pages i j to 20) 



Syphilis pravorum = e coitti illicita " 
(venereal syphilis) 

Syphilis insontium ingenita 
(hereditary syphilis) 

Syphilis insontium e coitu legitima 
(marital syphilis) 



not considered 

in present 

work. 



SYPHILIS INSONTIUM SINE COITU. 
A. SYPHILIS PANDEMICA. 

I. SYPHILIS EPIDEMICA. 

The various kinds of epidemics are given in a chronological order, relating 
to the successive appearance of new modes of transmission. After the re- 
porter's name is placed the year of the epidemic, or of its observation. Indi- 
vidual cases illustrating many of these will also be found later on under 
proper headings.* 

1. CUPPING. 

Geigel 1 (1615). Hardh, J. O. (1S72). Hjelt 1 , 2 - 3 (1858, 1858, (?) i860). 

HORNUNG (LAMMERT) (1596-g). HORST 3 (SnITZKK) (1603). JoRDANUS (i 577). LAM- 

mert 1 (1599, 1603). Meyer- Ahrens (1592). Poliataieff (1890). Spoof (1873). 

WlDMANN (HORST 4 ) (1624). 

*The full references to these facts are found in the succeeding Analytical Bibliography, under 
authors' names, alphabetically arranged. The small figures relate to the number of the separate 
observations, chronologically arranged. 

15 



2io SYPHILIS INSONTIUM 



2. breast-drawing. 
Alberti (1746). Barry (1728). Bilguer (Rosen von Rosenstein) (1775 ?). 

BOURGOGNE 1 (FOURNIER) (1825). CANETTA (1847). EvERARDUS (1654). HeIN- 

ecken (1S00). Hey (1770). Joly (1S53). Leloir 7 (1880). Leo (1892). Loder 2 
(1798). Munninks (1804). Ricordi l (1863). 

3. HAND-FEEDING. 

Musitanus (late in 17th century). Ricordi (1862). 

4. LACTATION. 

Balducci (1S67). Bardinet (1841). Barry (1728). Bertherand 2 (1873). 
Bouchacourt (1S41). Bouchut 3 (1867). Cantilona (1867). Demarchi (1S58- 
67). Depaul 1 (1849). Durante (Demarchi, Tanturri) (1S67). Dusterdorf 

(1826). FACEN (1849). FRIEDLANDER 1 (1884). GlBERT x (1837). LuSITANUS 

(1554). Pancritius 3 (1SS1). Pellizzari, C 8 (i882). Portal (Morand and 
Lassonne, Lugol) (1844). Raulin (Rollet) (1752). Ricordi 4 , 5 (1S63, two 6 , 
1S64 7 , 1S65). Ruggiere (Demarchi, Tanturri) (1S67). Selli (Demarchi, 
Durante, Ruggiere, Tanturri) (1867). Settegast (Hacker) (1823). Snell 1 
(1882). Tanturri 1 . 2 (1867). Vercelloni (late in 17th century). Viani 
(Depaul) (1849). 

5. accouchement. 
Bardinet 6 (1873). Bayer (1727). Bleynie (Bardinet 7 ) (1855). Booth 
(1883). Boudinet (1878). Bourgeois, or Burgesius (Rosen von Rosenstein) 

(1608). COHANSEN (1744). COLLES 5 , 8 (HEALEY) (1S37). DuTSCHINSKI (1889). 

Fuchs(i737). Gardane 1 (1775). Hime (18S3). Price, J. H. 4 (Gross) (1S86). 
Swediaur 2 (1S01). Wendt 1 (Walch) (i8ii). Wigglesworth 2 (1879). 

6. circumcision. 

BlERKOWSKI (KOSINSKI, LUBELSKI 1 , MaTLAKOWSKI) (1S33). BrECKER (JaFFE) 

(1S40). Kedotoff (1S84). Hutchinson 23 (Macnamara) (1886). Nowakowski 

(KOSINSKI, LUBELSKI, MATLAKOWSKi) (i 864-5). VON PlTHA (JaFFE) (1S67). 

Ricord 23 (1S52, 1S62). Rust 3 , 4 (1805). Solomon (in Hamburgh) (1846). 
Wendt 2 (1805). 

7. vaccination. 

Adelasio ] > 2 (Quarenghi, Viennois) (1862). Alies (doubtful : 1S41). Ben- 
nett, J. E. (1S63). Cerioli 1 (Barbantini ', Viennois) (1S21). Clary and 
Guary 1 (1866-7). Depaul and Roger 6 (Closmadeuc) (1S66). Desjardins 
(Layet) (tSSi). Dunn, Eulenberg (Freund) (1872). Ewertzen (1S30). Freund 
(1S76). Gallia (18S5). Galligo ' (1S57). Glatter (1S62). Grancint and 
Dall' Acqua (Sormanni) (1S73). Heine (Escherich, Heyfelder, Hubner) 
(1852). Hutchinson (1S79). Jones (Foster, Hubbard) (several episodes during 
the civil war 1S61, 1S66). Klein 1 (Rutiienberg) (1816-17). KObner 14 (table of 
principal vaccinal epidemics). Koceyar (1S69). Lacheze (1S62). Marcolini 
(Barbantini l , Viennois) (1S14). Marone ' (Bouvier ] ) (1856). Millard ' (1865). 
Mori (1870). Otterson (Foster) (1S62). Pacciiiotti » (Cerisi) (1861). Peola 
(1873). Percival (Jones, Foster) (1866). Polin (1882). Signorini (1888). 
Tassani (Cerioli 2 , Viennois) (1S41). Wegeler (Viennois) (1849). 



SYNOPSIS OF FACTS AND LITERATURE 211 

8. EATING AND DRINKING AND DOMESTIC PROPAGATION. 

Bassereau 2 (1852) (family). Bataschoff ] (1890) (local epidemic in Rus- 
sian villages). Boeck, W. 2 (1852) (family). Cazenaye 9 (1850-1) (family). 
Cold '. 2 (1859) (family). Cusack 1 (1837) (family). Demarchi (Ruggiere, Tan- 
turri) (1857) (family). Depaul 1 (1865) (family). Dron 6 (iS 70) (family). Est- 
lander (1870) (family). Flamande (Rollet) (1828) (eating and drinking). 
Fournier 30 (1880) (family). Friedlander 8 , 9 (18S4) (family). Garson (1848) 
(family). Gulli (1837) (family). Guntz" (1883) (family). Hjort (1844) 
(family). Hoffmann 2 (1739) (family). Jarotsky 2 , 3 (1891) (family). Kobner 8 
(1862) (family). Lagrange (1S63) (family). Lang 6 (1884) (family). Meyer- 
Ahrens (1844) (sheltering wayfarers). Morgan 4 (1872) (family). Pare (1585) 
(family). Poray-Koschitz 2 (1881) (family). Prehn (Bolschwing) (1832) (shel- 
tering wayfarers). Roussel 2 (1 881) (family). Rust ] (1823) (family). Simon 2 
(1858) (family). Steffens (1S41) (family). Sturge 2 (1S77) (family). Taylor 25 
(1891) (family). Velten (1830) (family). 

9. tattooing. 
Arthur 2 (Wilcox) (1886). Barker, F. R. (1888). Josias (1879). Maury 
and Dulles 1 (1878). Petry (1S58). Whitehead (1889). 

IO. GLASS-BLOWING. 

Dechaux (Guinand 2 ) (1867-9). Guinand (1863). Heiberg (1883). VlEN- 
nois 12 (Guinand) (1862). 

11. eustachian catheterization. 
Blauchet. Burow (1S86). Fournier and others (1 862-1 882). Martin 3 
(1876). 

12. APPLICATION OF TONGUE TO EYE. 

Tepljaschin 1 (1S86). 



II. SYPHILIS EXDEMICA. 

The endemic affections now recognized as syphilis are given in the order 
of their appearance ; the names of the most authentic and accessible authori- 
ties are appended. 

1. sibbens. 

Adams, J. 1 (1S07). Bell, B. 2 (1792). Gilchrist (1769). Hacker 2 (1851). 
Hibbert (1826). Milton (iS7q). Rollet 17 (1SS1). Skae (1844). Wille- 
moes (1S10). Wills fiS44). Wright (1855). 

2. radesyge. 
AxoNYMous 2 a (Beiirend) (1837). Arbo(i792). Bang(i778). Boeck, W. 
7 a (i860). Bonneyie (175S). Cederskjold (1S14). Craigie (1836). Hacker 2 

(1851). Hkxsllr (1799). Hjort 1 (1S40). HCnkfeld (1S28). LANCEREAUX 5 a 
(1869). Munk (1799). Rollet 9 a (1866/ Sprakel (1864). Steffens (1774). 

3. amboyna pimple. 

Bontius (1718). 



212 SYPHILIS INSONTIUM 

4. disease of st. paul's bay. 
Adams (1807). Cochran (1854). Fuchs' 1 (1840). Stratton (1835). 
Swediaur 4 (1S01). 

5. MORBUS DITHMARENSIS. 

Brandis (1813). Duhrsen (1S32). Francke (1838). Genters (1878). 

HELWEG (l82l). HtJEBENER (l82l). MlCHAELSEN (i 842). STRUVE (1S20). 

6. facaldina. 

Facen 2 (1849). Hacker 2 (1851). Marcolini 2 (1839). Sigmund 8 * (1855). 
Valenzasca (1840). Zecchinelli. 

7. scherlievo. 

Boue (1814). Cambieri (1812). Hacker 2 (1851). Jenniker (1819). Lor- 

ENZUTTI (1830). LORINSER (1865). MlCHAHELLES (1833). MOULON (1834). 

Ozanam. Pernhoffer (1868). Sigmund (1855). Zeissl, M. 2 (] 



8. mal di breno. 
Anonymous 13 (Lancereaux). Michahelles (1833). Sigmund (1855). 

9. FRENGA. 

Gamberint (1871). Sigmund (1855). Wibmer - (1841). 

io. spirocolon. 
Hacker (1851). Lancereaux (1868). Olympios (1840). Pollis (1842). 
Quitzmann. Wibmer 1 (1 841). 

ii. morulus (button scurvy). 
Corrigan (1835). Wallace (1838). 

12. mal kabyle. 
Arnould (1862). Vincent (1862). 

13. yang-mey-tchonang. 
Dabry (1863). 

14. syphiloid of jutland, lithuania, hesse, and esthonia. 
Albers(i836). Bolschwing(i839).' Hacker 2 (1 851). Ilisch (1822). Lillie 
(1777). Otto (1839). Schnur (1837). Tiling (1833). Van Deurs (1835/. 

15. ? yaws, pi an, framboesia. 
Adams (1807). Charlouis (1SS1). Christie (1887). Fox, T. (1876). 
Hacker 2 (1851). Hibbert (1826). Lancereaux (1868). Maxwell (1S39). Mil- 

ROY (1873). PONTOPPIDAN (1882). 

l6. ? ALEPPO EVIL. (DELHI BOIL, BOUTON DE BISKRA, CHANCRE DU SAHARA, 
CANEOTICA, ETC). 

Altounyan (1885). Bertherand (1854). Carter (1876). Fox, T. (1S76). 
Geiskr (1S75). Rigler (1S54). Russell (1S56). Willemin (1S54). 



SYNOPSIS OF FACTS AND LITERATURE 213 

B. SYPHILIS SPORADICA.* 

I. SYPHILIS ECONOMICA. 

This section has two main divisions, relating to, A. Infection in domestic 
and social life ; and, B. Infection in industrial pursuits. 

A. Infection in domestic and social relations, including, 1. Infection by- 
eating and drinking and use of tobacco, etc. ; 2. By personal and household 
effects; 3. By active and temporary contact ; 4. By passive contact. 

1. Infection by eating and drinking and by means of tobacco, etc. 1. 
By implements and vessels; 2. By smoking, etc. 

1. Infection by eating and drinking utensils, a. By spoons, knives and forks; 
b. By drinking vessels. (The majority of individual cases recorded fall under 
Section II., Syphilis brephotrophica). 

a. Infection by spoons, knives and forks. 
Bolschwing 2 . Diemer 6 . Froelich 5 , tonsil. Gluck 4 , lip. Krowczynski 1 , 
palate. Lee, H. 6 , tongue. Neumann 27 , tonsil. Poray-Koschitz 35 , tonsil. 
Pospelow 13 , fauces. Roddick 3 , tonsil. Viennois 4 , tonsil. 

b. Infection by drinking vessels : cups, glasses, jugs, faucets, flasks, etc. 

Arthur 3 (Fitz), lip (faucet). Boeck, C. 9 , tonsil (glass). Botallus, lip 
(glass). Bryce, lip (flask). Buchholz (glass). Cooper, A. 6 , lip (cup). Cull- 
erier, A. 8 (Hillairet), lip (glass). Dixwell (vessel). Fournier 56 (bottle). 
Girode, gum (glass). Gottheil, lip (cup). Griffin 1 , lip (pail), 8 lip (flask). 
Gruner (glass). Guibout 1 (Ory) 8 , lip (glass). Guntz ] , lip (glass). Jullien 6 
(Verneuil), tonsil (glass). Kogan, lip (glass). Lasch, chin and lip (glass). 
Lydston 5 , lip (cup). McGuire 1 , lip (vessel). Mra^ek 2 , tongue (vessel). Pel- 
izzari, C. 13 , lip (glass), 1( lip (public fount). Polotebnoff 7 (cup). Ricord 2 , 
fauces (glass). Taylor 8 , mouth (cup), 12 lip (cup). Vidal, E. (Ory) 7 , lip (glass). 

c. Eating and drinking, in a general way, with or without express proof of 
individual cases or utensils employed. 

Bell, B. 1 (drinking ware) 2 " Sibbens." Bell, J., tongue (pipe or dishes). 
Boeck, C. c , tonsil (table-ware). Bolschwing 1 , lip (cup and spoon) 9 "Syph- 
iloid." Buchanan, throat (spoons and pipe) "Sibbens." Cullerier, M. (Re- 
nard), (cup and spoon) references unknown. Danielssen also (Hjort, Cold, 
Si 11 1 en), probable infection by eating and drinking. Demarchi, epidemic at 
Capistrello and Castellafiume, eating and drinking utensils chief agents. 
Everardus, also (Blancaard), in an account of " Lues nova recrudescens." in 
Seeland (see epidemics), mention eating and drmking-ware categorically. 
Flamande, account of the Mai de Chavanne-Lure spread by eating and drinking. 
Clatter (family utensils). Graarud, tonsil (glasses or pipes). Heisler 2 , 
tonsil (eating or drmking-ware). Hjelt, description of promiscuous drinking 
among the Finns. Lanz, tongue (table-ware). Leidenberg, Syphilis among 
Russian peasants, largely by eating and drinking. Manassein, lip (mess 

* In attempting to make an analytical synopsis of tlie facts and literature relative' to various modes 
of transmission, it is of course impossible to exercise any critical judgment in regard to the correi tness 
of the statements made ; the alleged methods of infection arc given for the convenience of those 
wishing to make further studies in any one direction. 



214 SYPHILIS INSONTIUM 

utensils). Neumann 17 , tonsil (table utensils), 22 (table-ware). Newsky, tongue 
(table-ware). Ostroumoff (utensils). Pellizzari, C. 11 , lip (utensils). Plu- 
mert 2 , lip (eating or drinking- ware). Prehn (by wayfarers, eating and drink- 
ing). Profeta 3 (utensils). Weinberg 3 (utensils). Zakharevitch, fauces, etc. 
(spoons, tumblers, etc.). 

2. Infection by means of smoking, and substances taken into the mouth, a. By 
tobacco pipes; b. By cigars infected by mouth; c. By cigars infected other- 
wise; d. By cigarettes; e. By chewing gum, etc. ; /. By other substances. 

a. Infection by tobacco pipes passed from o7ie to another. 

Arthur 6 . Barling, lip. Baum 2 , lip. Behrend 6 . Besnier 6 , tonsil. 
Boeck, W. 14 , tongue. Bolschwing 7 . Bumstead 6 . Denis-Dumont 1 . Diemer 5 . 
Guignard 3 , tongue. Hufeland. Keyes 3 . 6 , lip. Lancereaux 2 . Lloyd 2 , lip. 
Ohmann-Dumesnil 1 , palate. Otis 4 , mouth. Pellizzari, C. 15 , lip. Profeta 5 . 
Quinquaud and Nicolle 1 , lip. Roddick 1 , lip. Wallace 3 , lip. 

b. Cigars, passed from one to another, often from stumps picked up. 

Ambrosoli ] , fauces. Campana 3 , buccal cavity. Drysdale 6 . Engelsted 2 , 
lip. Finger 3 , lip. Froelich 8 , lip. Gamberini 2 , lip. Kirkpatrigk, lip. 
Neumann 23 , corner mouth. Price, J. H. 2 . 

c. Cigars infected indirectly by various methods. 

Behrend 4 (cigars bitten off and returned to the box). Bulkley 1 (infected 
on lips in manufacture). Gottheil (same). Henning 2 (same). Kluge (infected 
by the hands in manufacture). Maunsell, lip. Rizat 1 , lip (cigar punch). 

d. Cigarettes infected by previous sjnoker. 

Budugoff 1 , lip. Conte, lip. Jakoleff 2 (corner mouth). Kreundel, lip. 
Lewy and Goldberg 8 , lip. Neumann 34 , lip. Popoff 3 . Serduckov 2 , tonsil, 3 
palate. Tchistjakoff 5 , inside cheek. Tzitrin. 

e. Chewing-gum , troches, etc., passed from mouth to mouth. 

Evmenieff (meats, breads, sweets, etc.). Griffin 2 , tonsil (candy). Hardy 1 , 
tonsil (lozenge). Leloir 13 , lip (chewing-gum), 1( lip (candy). Neumann 10 , 
tonsil (candy). Taylor 20 (chewing-gum). Valcourt, tonsil (lozenge). 

f. By other substances. 

Giovannini 3 , lip (gnawing a bone after a syphilitic). 

2. Infection by personal and household effects; a. By wearing apparel, 
etc. ; b. By bedding ; c. By toilet articles ; d. By miscellaneous articles. 

I. Infection by wearing apparel, a. By shirts, drawers, trousers, etc. ; b. By 
masks; c. By plasters, bandages, etc. 

a. Infection by wearing apparel proper. 

Acton 3 (pantaloons). Albinus, Barbantini - (mother's chemise). Bell, B. 3 , 
scrotum (trousers). Bondkt, scrotum (trousers). Botallus, Bulkley (bathing 
suit). Calderini (31 infected through unclean linen). Clerc 3 , scrotum. 
Dzondi, groin (under-garment). Fracanzianus, genitals (under-garment). 



SYNOPSIS OF FACTS AND LITERATURE 215 

Henning l (hat band). Hild anus l (pantaloons, 3 stockings). Jullien 1 , neck. 
Leloir 10 , eye (from glove). Polailon, foot (from shoe). Profeta 10 , foot 
(from shoe). Taylor 20 (bathing suit, drawers). 

b. Infection by masks. 
Ricord. Robert, M. 

c. Infection by plasters, bandages, etc. , in do??iestic use. 

Bjorken \ hand (plaster). Bulkley, neck (court-plaster, original case No. 
CXI.). Fournter 46 . Gltgnard 5 , forehead (dressings). Pellizzari, C. 1S , cheek 
and subclavicular region (plaster). Ricordi 2 , nipple (dressings). Righter, 
ear (court-plaster). Taylor 20 (plaster). 

2. Infection by bedding, a. By pillows ; b. By other bedding. 

a. Infection by pillows, drenched with saliva or pus. 
Jullien 3 , neck. Salsotto 4 , cheek. Sauvages, head. Taylor 20 . 

b. Infection by sheets, or anything except pillows. 
Danielssen. Guyon. Massa 5 . Popoff 31 . Puche 2 (Acton) 2 (prison cot). 

3. Infection by toilet articles. . a. By towels, sponges, etc. ; b. By combs and 
brushes ; c. By tooth-brushes ; d. By syringes ; e. By privy seats, etc. 

Infection by towels, sponges, etc. 

Arning 2 , nostril (towel). Barker, E. (towel). Baum 6 , eyelid (towel). 
Blanc 2 , cheek (towel). Fenwick, eyelid (towel). Froloff, eyelid (towel). 
Hill 3 , gum (towel). Hutchinson 7 , finger (towel). OsTROUMOFFf (towels). 
Pospelow 18 , nose (towel). Price, J. H. 6 (Sims 3 ), eye (towels and basins). 
Rona 4 , eyelid (towel). Sigmund 7 , labia (sponge). Stanley, lip (towel). 
Taylor 9 . 2) (towel). 

b. Infection by combs and brushes. 

Bourgogne 3 (comb). Elliotson (comb). Horteloup, P. 4 (brush). Pro- 
feta 9 , scalp (comb). Tzitrin (combs). 

c. Infection by tooth brushes, etc. 

Baxter (tooth brush). Blumenbach (tooth brush). Bumstead 4 (tooth 
brush). Haslunu ', tonsil (tooth brush). Knight *, tonsil (tooth powder). 
Mackay (toothpick). Penny 2 , gum (tooth brush). 
d. Infection by syringes. 
Fournier 9 . Jullien 2 . Leloir 12 . 

c. Infection by privy seats, etc. 
Fallopius, buttocks. Fitzgibbon 2 , thigh. Loder 1 . Marc 2 . Roddick 10 , 
penis. Taylor 21 . 

4. Infection by miscellaneous articles of convenience, a. By handkerchiefs, 
napkins, etc. ; b. By pins, etc. 

a. Handkerchiefs, napkins, aprons, etc. 
Agasaroff (handkerchief). Atkinson 6 , nostril (handkerchief). Leloir 1 , 
commissure (handkerchief). Petersen", lip (napkin). Pospelow " ; , eyelid 
(apron). Taylor 20 (handkerchief). 



216 SYPHILIS INSONTIUM 

b. Infection by pins, etc. 
Bulkley, tongue (original case No. LXXXIX). Koch, finger (drawing 
instrument soiled with saliva). 

c. Infection by canes. 
Otis a (mention of such mode of infection). 

d. Infection by opera glasses. 
Falcone, eyelid. 

e. Infection by other methods in fa7nily life. 

Evmenieff (playthings). Galippe (toys). Griffin- 5 , lip (rouge). Kleiner^ 
lip (vaseline). Profeta 6 (bread, etc.). 

Other instances of domestic infection, in which the methods are not specified. 

Anonymous q, m . Atkinson 4 , cheek (from parents). Belousow 1 , breast, 
lip, tongue, soft-palate, tonsils 2 , 3 , 6 , 10 . Biett 2 (infant infects mother). Boeck, 
C. 5 . Boeck, W. 3 (by mother) 4 . Bronson 1 , tonsil (from mother). Bryant \ lip 
(from father). Chambay (child by mother). Colles 4 , lip, breast (family epi- 
demic). Drysdale 2 (room-mate). Eltzina 1 . Emser. Faguer, tonsil. 
Feularu 6 , cheek (from uncle). Fournier 46 , 51 . Fox, T. C, lip. Gemma 1 . 
Griffin 7 , lip (from husband), 9 tongue (from husband), ]1 lip (from husband). 
Hauner 3 (from father or mother), 4 (from grandmother). Hayward 4 (grand- 
mother). Henrot (mother from infant). Herzenstein l . Hoffman i , nose 
(from servant). Jarotsky 1 . Jelzina 1 . Junquet 2 , 3 . Karamanenko 2 . 3 » 4 . 
Kaverin 3 . Kolokolow, lip. Lazansky. Leblanc 1 . Lee, H. 4 , 5 . Lubin- 
sky 1 ) 5 . McGuire 4 , tonsil. Marjoline. Marlow, eyelid. Marmisse. 
Massa 4 . Mauriac 3 . Michel 1 , eyelid. Mikhailoff 2 , Monnet 1 , 2 , 3 , cheek, 
lip and mouth (by mother). Morgan ] , mouth. Nasse 2 , gum. Neumann 1 , 
tongue. Ory 7 . Pacchiotti 4 , tonsil. Pellizzari, C. 3 , tonsil, 4 , 7 angle of 
mouth, 12 ' 16 . Petersen 3 , lip. Petrini 12 . Polotebnoff 1 . 4 , 5 > 6 . Pontet 5 , lip. 
Popoff 1 . 3 . Poray-Koschitz 7 , tonsil, 10 lip, 13 mouth, 15 tonsil, 17 palate, 
29 buccal, 32 > 33 » 34 fauces. Pospelow 10 , fauces, tonsil. Price, D. Price, J. H. 1 . 
Rafinesque. Reiche. Robert, A. Roche 2 ? 3 . Roger 1 . Rollet 8 , tonsil. 
Romanoff. Roussel 4 , throat 9 , 10 . Sabinin. Schnur. Selenew 1 , tonsil. 
Shand 2 , mouth. Sims 2 . Soler 2 , lip. Sotchara. Ssabinin. Stein. 
Stoll 1 ' 2 ' 3 . Sturgis 3 , cheek. Tardieu 9 . 10 . Taylor 2 , lip 23 . Theobald ', lip. 
Toujan 2 , lip (from husband). Trevisanello 1 , tonsil. Van Dugteren and 
Van Walsem 2 , tonsil (from father), 3 lip. Van Harlingen 2 . Verneuil 5 . 
Viennois V 9 . Wallace 2 , throat. Waller' 2 , 7 . Weil 2 . Wildbore. Wild- 
hagen 2 , lip (room-mate). Wilson 1 . 

3. Infection by active and temporary contact, in domestic and 
social life; i. Buccal; 2. Digital. 

I. Buccal infection, by contact in domestic and social life; I. By kissing; 
2. By biting. 

1. Infection from active and limited contact, in kissing; a. Reciprocal; b. Non- 
reciprocal. 

a. Infection from reciprocal kissing, lip to lip. 

Alberti ("de osculo morbifero, etc.," known only by title). ANONYMOUSa, 
mouth. Arthur 5 . Atkinson 1 , lip. B.erknsprung 2 , lip. Barduzzi 3 , lip. 



SYNOPSIS OF FACTS AND LITERATURE 217 

Bassereau 3 , lip. Baum 4 , lip. Bell, B. 1 . Bertherand 1 , tonsil. Biett 4 , 5 
(Cazenave), lip. Boeck, C. 4 , tonsil. Botallus. BCdugoff 2 , tonsil. Bulkley. 
Bush, lip. Capuron 4 , lip. Cassidy, lip. Cazenave 6 , fauces. Chisholm, lip. 
Chrestien 3 (Simoneau), tongue. Colles 1 . Cullerier, M. 2 , lip 3 (Cazenave), 
lip. DeMeric, tonsil. Draper, lip. Drysdale", lip. Elliot, fauces. 
Erichsen 1 , tongue 2 . Eustachius 3 , tongue. Fabre, fauces. F aught, gum. 
Fernelius 2 , lip. Fox, G. H. s , lip. Froelich 9 , lip. Gabalda, lip. Galligo 2 . 
Gamberini 1 , lip. Gay, A. H. 3 . Gibert 6 , tonsil. Gluck 6 , tonsil. Gratia 1 , lip. 
Griffin 6 , n > 12 > 13 , lip. Gross 1 , lip 3 . Guntz 7 , 1 \ lip 16 . Haslund 3 , tonsil. 
Heisler 1 , chin. Henry 1 , lip. Hu lot, gum. Jakoleff 1 , lip. Keyes 2 * 5 , lip. 
Lallemand 4 , lip. Lang 7 , lip. Langenbeck. Langlebert 3 , lip. Lavergne 
and Perrin 8 , lip. Lee, H. 6 , tongue. Lefeuvre, lip. Lewin 3 , lip, 5 . 6 lip. 
Lindestolpe. Lydston 3 , tongue. McGltre 3 . Manganotte, lip. Marc 1 
(Roux), tonsil. Margontner 1 , lip. Mauriac. Minot, lip. Morgan 2 , lip. 
Mracek 1 , lip. Neumann 21 , lip, 22 lip. Notta, lip. Ory 6 (Lailler), lip. 
Ostroumoff f . Otis 3 , 8 , lip. Pancritius 5 , lip, 6 tonsil. Partridge, lip. 
Petersen 6 , gum. Popoff 3 . Poray-Koschitz 8 , lip. Porter, W. H. (Pratt), 
tonsil. Pospelow 11 , fauces. Price, J. H. 3 (Gross), 4 lip. Renard, tonsil. 
Reumont, lip. Ricord 22 , lip. Roddick 4 , lip. Rollet 6 . Saleneuve, tongue. 
Schlegel. Schneider (Plouquet), " per salivam osculum". Shoemaker, lip. 
Sigmund. Stirling 1 . Stukowenkow 1 , tonsil. Sutton. Temple, lip. 
Thomas 1 , lip. Van Harlingen 4 , lip, 7 tongue. Victorius, lip. Vidal, E. 4 , 
tonsil. Viennois 3 , lip. Walter 2 , 3 , lip. Willi. 

b. Non-reciprocal kissing, lips to other parts. 

Abadie (Viguier 2 ), eyelid. Alexander 1 , eyelid. Audoynaud 2 (Fournter), 
breast. Ayres(De Beck), eyelid. Barduzzi 4 , cheek. Benson, eyelid. Bloom 2 , 
angle jaw. Boucheron 1 , eyelid. Bryant 5 , nipple. Bumstead 2 , nipple. 
Davis (nurse, nursling). Dupre, eyelid. Fournier 1 ', nipple. Gratia 1 , 
eyelid. Herard 2 , nipple?. Johnson 1 , nipple. Lavergne and Perrin 7 , 
breast. Leloir 1 , toes. MacKenzie, W. 2 , conjunctiva. Mracek 4 , behind 
ear, 8 nipple. Neumann 24 , cheek, "chin, 31 nipple ?. Pospelow 3 , chin. 

Renault, neck. Riciion, eyelid. Ricord 11 , breast. Salsotto 4 , eyelid. 
Sattler (De Beck), conjunctiva. Tenneson, cheek. Touchaleaume, eyelid. 
Watson, S. 1 , cheek. Wecker 2 , conjunctiva. Zabolotski, eyelid. Zeissl, H. 5 , 
cheek. Zucker, ear. 

2. Infection from biting: a. Asa caress; b. In defence or assault ; c. Acci- 
dental tooth wounds. 

a. Biting as a form of caress. 

Baum 7 , cheek. Blasciiko, lip. Boyer 2 , nipple in male. Browne, check. 
Buzenet 2 , tongue. Clements, lip. Dunn 2 , lip. Fournier 1C , neck. Froelich 7 , 
nipple. Gamberini 4 , cheek. Herard'-, nipple?. Kaposi 1 , lip. Neumann- 1 , 
lip, 31 nipple?. Rollet', 10 , lip, tongue. Taylor 14 , nipple in male, 21 lip. 
Van Harlingen 1 , 2 , lip, 6 mouth. ° nipple. Zeissl, H.°, breast. 

b. Biting in defence or assault. 

Arthur 7 , lip, chin. Baratoux, car. Beauvais 1 , finger, *(Gery), hand. 
Berbez (Guignard 7 ), finger. Blaciiez, neck. Brinton (Rohe >), nose. Brown, 



218 SYPHILIS INSONTIUM 

F. T., finger. Bucci, finger. Bumstead (Sturgis ] ), cheek. Campart 5 , eyelid. 
Carriere, thumb. Finger 4 , nose, ear, thumb, toe. Froelich 6 , wrist. Gam- 
berini 4 , neck, 7 (Buccj), finger. Giovannini 10 , finger. Guignard 4 , nose. 
Henry 3 , cheek. Horteloup, P. 2 (Simonet) \ cheek. Hutchinson, J. 29 . Jones, 
S.,hand. Kaposi 4 , chin. Lavergne andPERRiN 2 , cheek, neck, ear, arm, finger. 
Lesage 1 (Fournier), thumb, 3 (Brouardel 3 ), finger, 6 (Fournier, Lavergne and 
Perrin), cheek, 7 (Hermet, Lavergne and Perrin), ear. Molliere (Jullien), 
finger. Morel-Lavallee 2 , eyebrow, 5 (Fournier), cheek. Neumann 4 , thumb, 9 
hand, 30 hand or finger. Pellizzari, C, chin, cheek, neck. Petersen 4 , cheek, 
8 finger. Poray-Koschitz 3 . Profeta ] , 2 , cheek. Robbins 4 . Roddick 3 , neck. 
Salsotto 4 , cheek. Soler 3 , cheek. Tarnowsky 3 , hip. Tchagin 3 , cheek. 
Vvedensky ] , finger. Walter 1 , lip. Zeisse, chin. Zeissl, H. 8 , thumb. 

c. Tooth-wounds accidentally inflicted. 

Bulkley, hand (original case No. CVII.). Chochlow 2 , finger (blow on 
teeth). Fournier 38 . Gazet, forehead (from dog-bite). Hutchinson, J. 3 , 
knuckle (fighting) 28 . Lesage 2 (Fournier), finger (policeman). Lunkevitch, 
finger (fighting). Maclaren *, finger. Speransky x , nose (fighting). Viguier 4 , 
cheek (in play). Wood l , knuckle (blow on tooth). 

2. Digital infection in domestic and social life ; i. By contact; 2. By nail 
wounds. 

i. Infection by contact of finger; a. Self inoculation; b. Inoculation of 
others. (Many of these cases are found also in other sections). 

a. A uto-inocidation by means of finger. 

Bryant 6 , finger (direct contact). Galezowski 5 , eyelid. Gratia 2 , eyelid 
(venereal). Hunter 1 , lip. Lang 10 , thumb (from own penis). Lawrence 4 , 
thumb (direct contact). Lee, H. 10 , finger (direct contact). Leloir 10 , eyelid. 
Lustreman, eyelid. Morfan, septum nasi. Marston (Lee, H. 6 ), face. Mazet, 
eyelid (from own penis). Michel 3 (Stellwag von Carion), eyelid. Moure 1 , 
septum nasi. Neumann 6 , finger. Ohmann-Dumesnil 2 , lip (from own penis). 
Peter 2 , finger (from own penis). Popoff 2 . Ricord 4 , eyelid. Sigmund 6 , finger 
(direct contact). Suchanek 5 , lip. Taylor 24 , finger. Wood 2 , finger (in 
barber). 

b. Inoculation of others by means of finger. 

Plumert 7 , breast (scratch by brother). Tchistiakoff 14 , head (wound 
infected by barber). 

2. Infection by nail wounds ; a. Scratching; b. Pinching. 

a. Infection by scratching. 

Allen, C. W. 7 , behind ear. Bryant 7 , cheek. Cooper, A. 4 hypogas- 
trium. Niece, elbow. Roddick 7 , forehead. Rollet 15 , chin. Taylor 26 , 
forehead. Vaughan, scalp. 

b. Infection by pinching. 
Weinberg 1 , cheek. 



SYNOPSIS OF FACTS AND LITERATURE 219 

4. Infection by passive contact in domestic and social relations; a. 
Contact in sleep ; b. In carrying or supporting. 

a. Non-venereal contact in bed. 

Bergh 2 , gluteal region. Bertherand 3 (Guyon). Broich 12 , thigh. Caze- 
nave 7 (Lagneau, Lucas-Championiere, Biett). Colle. Corrigan ("button 
scurvy"). De Beck 1 , eyelid. Drysdale 2 , vulva. Friedlander 3 . Hauner 6 . 
Hildanus 2 . Horst 1 . Hulot, trochanter. Lancereaux 4 (Rayer 2 ). La- 
vergne and Perrin 4 , thigh. Mauriac 4 , back. Mracek 7 , wrist. Osiander. 
Pospelow 19 , chin. 

b. Contact in carrying, supporting, etc. 

Fontanus (mere contact). Fournier (Jumon 5 ), front thigh (holding 
woman in lap). Pellizzari, C. 19 , sub-maxillary region (contact with chancre of 
chin), 26 tonsil, neck, cheek, arm, chin, chest, mouth, anus (all from contact). 
Rizat 4 (Si.monet 2 , Chipier), nucha (carrying woman), 6 abdomen (contact;. 
Tarnowsky 3 , arm (contact with chancre of hip). 

B. Infection in industrial relations; 1. Buccal infection; 2. Digital infection. 

1. Buccal infection in industrial relations; i. By occupations requiring 
the use of the breath; 2. By necessary or unnecessary use of the lips. 

1. Industrial infection by occupations requiring the use of the breath; a. Glass- 
blowers; b. Assayers; c. Weavers; d. Musicians; e. Conductors;/. Housemaids. 

a. Infection of glassblowers. 

Anonymous , lip. Aubert 1 , lip. Bazin 2 . Bernard, A. 1 . Besnier 3 a, 3 1> . 
Chassagny. Dechaux (Gltnand 2 ). Deffernez. Desmet 2 . Diday 10 , I2 , lip. 
Dron 7 , lip. Gailleton. Gamet 1 . Gromier, lip. Guinand 4 , 5 . Heiberg. 
Hervier. Lagrange. Mason 2 , lip. Niobis. Perroud 1 , lip. Ravogli and 
Rasori 3 . Roddick 8 , lip Rollet 5 , lip 12 . Sigmund 11 , lip (four cases). Vien- 
nois 2 , lip, 8 lip, 9 tonsil, 10 fauces ». . Villard, lip. 

(Statistics of Hosp. Antiquaille, Lyons, from 1858 to 1872, furnish 82 cases; 
many included in the above. Besnier, Dron, Gailleton, Perroud, Rollet). 

b. Infection of assayers by use of the blowpipe. 

Margoniner 2 , palate (goldsmith's blowpipe). Sigmund n a, lip (three 
cases, two of them infected from same person). 

c. Infection of weavers. 

Behrend ' (entire family infected by mouth sprinkling-pipe). 

d. Infection of musicians from wind instruments. 

Greenleaf, lip (cornet). Guntz 6 . Lesage 4 (clarionette). Mason 3 , lip 
(cornet). Pospelow 6 , gum (clarionette). Roussel 5 (cornet). Sigmund. 
Tedenet, lip (cornet). Viguier 7 , inside cheek (cornet), 8 tonsil (flute). 

e. Infection of conductors of street conveyances or others using signalling whistles. 

Gros, lip, (bus conductor). Taylor 2 '. 



220 SYPHILIS INSONTIUM 

f. Infection of domestics or others using speaking-tubes. 
Martineau 2 , lip. Vidal, E. 2 , lip. 

2. Buccal infection in industrial relations, from the necessary or unnecessary 
use of the lips : a. Cooks ; b. Furriers ; c. Upholsterers and Shoemakers ; 
d. Clerks ; e. Cashiers ; f Other occupations. 

a. Infection of cooks front the ?ise of the tasthtg-spoon. 

JuLLiEN 4 t>. Rollet 7 , lip. Schirajew ] , tonsil. Tchistiakoff 6 , inside 
of cheek. 

b. Infection of furriers fro7n common use of thread in mouth. 

Poray-Koschitz l , lip (three men infected from a fourth). 

c. Infection of upholsterers and shoemakers from tacks or pegs held in mouth while at 
work (the surplus being thrown into the common receptacle). 

Pospelow 7 , tongue (from shoemakers' pegs). Spillman 2 , lip. Steele, lip. 

d. Infection of clerks and others, by writing implements, etc., held in the lips. 

Bangs (Fox, G. H. 7 ), gum (pencil). Calmette, tonsil (pencil). Cullerier, 
A. 6 , lip (pencil). Daehne, lip (quill-pen). Fournier (Jumon 4 ) (paper-knife). 
Gluck 5 , lip (pencil). Morel-Lav allee 6 , tonsil (pencil). Otis 6 , lip (pencil). 
Richerand (quill-pen). Ricord 18 , lip (quill-pen). Rohe 2 , tongue (pencil). 
Sigmund (brush-holder). 

e. Infectioit of cashiers and others from corns and bank-notes held in the lips. 

Desnos 1 , tongue (bank-notes). Fitzgibbon 1 , lip (bank-notes). Robinson, 
T. 2 , lip (coins). 

f Buccal infection in other occupations. 

Audry, lip (gunsmith). Besnier 2 a, lip and tongue (from brush of work- 
man). Guntz 6 , lip (flower maker). Karamanenko 2 (fieldwork). Popoff 3 
(military service). 

2. Digital infection in industrial relations: a. Laundresses; b. Dealers 
in old clothes, ragpickers and others. 

a. Infection of laundresses and chambermaids. 

Anonymous i , finger. Boeck, C 1 , finger. Bottey, hand. Dornig, eye- 
lid. Froelicii 3 , arm. Guntz 12 . Hamande, eyelid. Maclaren 2 , thumb. 
Neumann 16 , arm, 30 hand. Roddick 9 , wrist. Tchagin 1 , eyelid. 

b. Infection of handlers of old clothing and ragpickers. 

Coyttarus (two sisters from cast-off clothing). Fournier (Bouilly *), 
finger (in a rag-sorter). 



SYNOPSIS OF FACTS AND IITERATURE 221 

II. SYPHILIS BREPHOTROPHICA. 

This section, relating to the acquiring of syphilis in connection with 
infant life, has two great subdivisions : A. As acquired by the child or others, 
through nutrition ; and, B. As acquired in connection with the care of infants, 
either by them or by others. Some of the subdivisions will be found to be the 
same as in the preceding section, and some references are interchangeable. 

A. Infection in connection with nutrition of infants, subdivided into, 

1. Infection by lactation ; and, 2. Infection by hand-feeding. 

1. Infection by lactation, relating to, a. Infection of nurse ; b. Infection 
of nursling. 

a. Xurse infected by nursling; 1. From nursling with hereditary syphilis; 

2. From infants with acquired syphilis. 

1. Infection of nurse (one or more), by a nursling with hereditary syphilis; 

including, a. Mother infected (exception to Colles' law) ; b. Nurse infected by 
nursling. 

a. Mother infected by own child with hereditary syphilis (exception to Colles' law). 

Bertin 5 . Cazenave 11 . Guibout 5 . Merz 2 (Zingalis). Pellizzari, P. 
(Jullien 12 ). Ranke. Scarenzio 5 . Tommasi-Crudeli. Zeissl, M. 1 (Luth). 

b. Nurse {not the mother) infected by nursling with hereditary syphilis. 

Abernethy 1 (Watson of Stourport). Acton 5 (family infection and law 
suit). Albers 3 . Ambrosoli 2 . Appay 3 , 4 (Fournier) ] , 2 > 6 (Le Dentu) 
Arcari 2 . Audoynaud ' (Fournier) 3 , 7 (Broca 2 ), 5 (Bazin 1 ), 8 , (Triboulet) 9 , (Sim 
onet 3 ), I0 (Charpentier), 6 (Siredey). Auxias-Turenne 1 . Bardinet 2 , 3 » f 
Barillier. Barnes. Baum 10 . Baumes 1 - 2 . Behrend 2 , 3 . Bell 2 . Bergeret 
Bertin 4 ! 6 (Leblaxc). Blondeau. Boeck, C. 1 . Boeck, W. 1 . 6 . Boerhave 2 , 3 , 
Bouchut 1 (Rayer '). Boyer *. Breda 1 , 2 . Bulkley. Bury. Byrne. Cam 
pana 1 . Campbell. Caradec Carle. Caspary ', 2 . Cazenave 2 , 10 , 
Chabrely. Chadzynski. Chrestien j (Niel), 2 (Menard *), 5 (D almas). Clary 
andGuARY 2 . Clerici. Colles 2 . 7 . Cullerier, M. 1 . Cullerier (nephew) 
(Lucas-Championniere *), (Diday 2 ). Cusack 1 *. Danielssen h 7 . DeAmicis 3 . 
Dease. Delore (Fournier 28 ). Devaux 2 . Dron h 2 > 3 » ■". 5 . Drysdale 4 i 8 . 
Dupuytren (Rognetta), also eyelid. Durkee ] (Bennett, J. H.) 2 . Ebrard. 
Egan 1 * 2 . Engelsted 4 , s. Farre. Forestus. Fortin. Fournier (earlier 
cases of 13 Appay, 8 Audoynaud, 2r) Hulot, etc.) 48 , 51 . Gamet 3 (Guinand '). 
Gardane 2 . Gauthier. Gavin. Gilbert (Vassal 3 ). Guillery. Haase'j 2 . 
Habenstreit. Hebra, F. von. Herzenstein >. Hjort 2 . Hofmann 2 . Hunter 2 . 
Hutchinson, J. 14 . Joiy. Keyes 4 . Klink. Kortum 2 . Lagneau, G. 1 , 3 
(Defaucambourge). Lallemand ', 2 (Souciiier). Lawrence b . Lee, H. 8 . 
Leloir 3 . 5 . Leonesio. Letorsay. Lewin 4 i 8 i 8 . Lowdell 1 . LuzinskyV, 6. 
Manning. Marmissk. Mensinga. Monteggia. Mora and Sorksina ', 2 . 
Morgan 3 . Neumanns 1 "-, 31 . O'Connor ] , W\ Ory 10 (Lailler). Pellizzari, 
C.i, 4, 5, e, 2i # Pellizzari, P. fl (Roster 2 ). Petrini '. Plumert '- s . Poi \k. 
Pospelow 5 . Price, D. Profeta. Putegnat '. 3 . Ravel. Ricordi k , u , 15 . 



222 SYPHILIS INSONTIUM 

RlZAT 7 . RlZZI. ROLLET J . SADOUL. SHERWELL 2 . SlGMUND 3 , 5 > 14 > 1S . SMITH, 

J. L. Sperino \ Sturge ». Suchanek ] > 2 . Tardieu h 2 , 6 > 7 > 8 , 9 , 10 , n , 12 . 
Taylor 3 , 4 > 5 . Thiry 3 . Trousseau 2 . Tchistiakoff 7 > 12 . Valery. 

Vassal h 2 , 3 . 

In the following class of cases, nurse {not the mother) infected by nursling, it is 
impossible to ascertain whether the infants in each case were subjects of hereditary or 
acqtiired syphilis. 

Anonymous l, m , r . Anstie. Archambault 1 (Pontet 4 ). Axenfeld. Bard- 
inet 1 . Belousow 2 , 3 . Berger. Berti. Beurmann. Biett 3 . Bigelow 1 . 
bottex. bouchut 2 . boys-de-loury. broick 3 . capuron 1 . cataneus. 
Chaboux 1 . Cheminade 2 . delChiappa 1 . Clarke, A. Cocchi. Cullerier, 
A. 1 . DeAmicis 1 . Des Molines. Diday \ 2 . Ellis. Eltzina 1 . Fernelius 1 . 
Foucart. Fournier 18 > 19 , 20 , 21 > 22 , 26 , 2S , 44 , 56 , 59 , 68 . Fredet 1, 2 . Froelich K Gail- 
leton. Galezowski l . Gemma 1 , 2 . Giovannini 4 . Guerrier. Hamerton 1 . 
Hardh, C. W. Hayward 1 . Hebra, H. Henri-de-Saint-Arnould. Her- 
zenstein 3 . Horteloup, E. and P. Jacquet. Jelzina 1 . Johnson 2 . Junquet 1 . 
Karamanenko \ Kehrer. Kobylin. Komin 1 , 2 . Langlebert 1 . Lee, H. 7 , 13 . 
Lefevre. Lewi 1 , 2 . Lindstrom 2 . Linne. McCraith 6 . Manassei. Mari- 
anelli 2 . Merz 1 . Michel, J. Mikhailoff 1 . Moore 3 . Musitanus. Oedmans- 
son. Pacchiotti 2 . Parker 2 . Perroud 2 . Petersen 7 . Petreni. Plinatus. 
Poggio. Polotebnoff 2 , 3 > 4 (Stein), 5 (Sotchara). Popoff 3 , 5 . Poray-Kos- 
chitz 19 > 23 > 24 . Quinquaud 1 . Rabl. Ravogli and Rasori 2 . Razumoff 1 , 3 . 
Reiche. Reichebach 2 . Rhodius. Ridley. Riverius. Roche '. 2 , 3 » 4 . Rod- 
dick 2 . Roger 4 . Sabinin. Salsotto 3 . San Juan. Sartorius. Scarenzio 1 . 
Skinner. Soffiantini. Soler 2 . Speransky 6 . Stepanoff J , 2 . Tanturri 3 . 
Torella. Townsend. Trevisanello 4 . Tuilier (Bardinet). Turati. 
Ussas 4 . Velschius. Verneuil 1 , 4 , 6 . Viennois. 1 Violet 2 . Waller 4 , 7 , 8 
(Suchanek). Weil 2 . Wildhagen 4 . Wiltshire. Zarewiez (Gluck j ). 

2. Infection of nurse by a nursling with acquired syphilis : including infant 
acquiring syphilis: a. From lactation; b. From kissing, etc.; c. From vacci- 
nation, etc. 

a. The infant's syphilis acquired in lactation. 

(In this section belong many cases in essential lactation-epidemics, where 
nurslings infect their own mothers and other nurses, and but few separate 
references can be made). 

Brassavola (nurse mother). Friedlander 2 (?). Gibert 3 (nurse mother). 
Lees (nurse mother) (Hutchinson 18 ). Obedenare (?). Pease 1 (nurse mother). 
Pospelow 5 (nurse mother). Schmalz 2 (nurse mother). Soler 5 (nurse 
mother). Wilson 2 (nurse mother). 

b. The infant's syphilis acquired by kissing or otherwise per os. 

Guenzberg 2 . Kilian 3 . Lewi 3 . McCraith 2 . Payne 2 . Poray-Koschitz 20 . 
Ricordi 10 , 12 . Rupp 2 . Taylor 7 . Theobald 2 . Tuholske. 

c. The infant's syphilis acquired by vaccination, circumcision, etc. 

(In this section belong those cases found in epidemics of vaccination, 



SYNOPSIS OF FACTS AND LITERATURE 223 

circumcision, etc., where the children have infected mothers and nurses, and 
few separate references can be given). 

Albers 2 (circumcision). Clary and Guary (vaccination). Depaul 7 . 
Friedlander 2 (?) (vaccination). Glatter (vaccination). Laroyenne ] (vaccina- 
tion). Middleton 2 (vaccination). Moseley (vaccination). Perrin 3 (vaccina- 
tion). Poray-Koschitz 21 > 22 (vaccination). Rodet 3 (vaccination). Solomon, 
J. V. 3 (vaccination). 

b. Nursling infected by nnrse or other nursling; 1. Nurse has chancre of 

breast; 2. Nurse has recent syphilis, but no chancre of breast; 3. Nipple 
serves as medium, from another nursling. 

1. The nurse, having been infected in lactation, has a chancre of the nipple. 

a. Nursling infected directly from nipple. 

Ambrosoli 2 . Baumes 2 . Behrend 3 . Boeck, W., 6 lip, 7 lip, 8 , 9 lip, 
11 tongue. Bottex. Bouchut 2 . Bulkley. Caspary K Colles 2 . Cullerier 
(nephew) (Lucas Championniere 1 ). Danielssen 1 . De Amicis 2 . Dron 4 
Engelsted 5 . Fournier 44 . Galezowski 2 , lip. Hayward 2 . Karamanenko 1 
Lagneau, G. 1 . Lewin 4 , 9 . Lowdell 2 . Luzinsky 2 . McCraith 3 , 5 

MONTEGGIA 1 , lip 5 . POLOTEBNOFF 5 . PoNTET 4 (ArCHAMBAULT 2 ). PRICE, D 

Ricordi 9 , 13 lip, 16 tongue. Rollet 3 , lip. Tanturri 3 . Trevisanello 4 , 5 
Verneuil 2 . Waller 5 . Weil 2 . 

2. The nurse has recent syphilis but no chancre of breast. 

a. Nursling infectedfro??i mztcous patches 071 breast. 

Agostini. Alison. Arning 1 . Barillier. Bergeret. Boerhaave 2 . 
Brassavola. Bruneau. Capuron 2 . Cerasi 2 , 3 . Chrestian 1 (Menard 2 ). Coote 1 . 
De Amicis 4 . Diemer 3 . Donne. Eustachius 1 (?). Forestus. Fournier 25 , 30 ! 49 
lip 52, 58,59, ci_ Friedlander 2 (?). Gibert 2 , lip. Guenzberg 1 , tongue 3 . Hamer- 
ton 1 . Heister. Hill 2 , 4 . Lanoix 1 . Lee, H. 12 . Legrand 1 . Lister. Luzinsky 1 , 3 * 6 . 
Meyer (in Mindeni). Mikailoff 3 . Monteggia 2 , 3 . Moore 5 . Obtulowicz. 
Pare. Pellizzari, C. 2 , 4 , c > 7 , 10 . Portal. Putegnat 2 . Roger 5 . Rosen v. 
Rosenstein 1 . Roster 3 . Schirajew 2 . Schmalz 1 . Shand. Sigmund 12 , lip. 
Soler 4 , tongue. Stahl. Stoll 3 . Thiry (Charpentier). Tchistiakoff 7 . 
Van Swieten. Venot. Vidal-de-Cassis. Waller 1 . Winters 1 . 

b. Nursling infected from nipple contaminated with soiled fingers, etc. 

Cullerier, A. (Ricord), (nurse contaminates nipple with finger from 
vulvar syphilides). 

c. Nursling infected by supposed transmission through the milk. 

Cerasi 1 . Manssurow 2 . Nunn 2 (Morris). Steinberger. 

3. Nipple the medium, another nursling the syphilifer. 

a. Nipple of the nurse the medium of transmission. 

Bertin 3 . Stoll 2 (nurse had not syphilis herself, but one child infected by 
another through the same nipple). 



(2 24 SYPHILIS INSONTIUM 

2. Infection by Handfeeding: relating to: a. Adults infected ; b. Infants 
infected. 

a. The attendant is infected by the child ; including i. Handfeeding of new 
born infants, generally with hereditary syphilis ; and 2. Weaning of children, 
generally with acquired syphilis ; considered together. 

a. Infection from the nursing bottle (by tasting it in connection with feeding the 

child). 

Appay 5 (Gondonin), tonsil. Bolschwing 3 , fauces. Drysdale 3 , throat. 
Fournier 3 (Hillairet). Hutchinson 32 . Gibert 4 . Kobner 5 . Lang 8 , tonsil. 
Lesser 1 . Macdonald, tonsil. Ryan, C. S. 2 , lip. Spillman 1 , tonsil. 

b. Infection from the artificial teat. 

Plumert 5 . Polotebnoff 3 (sucking horn). 

c. Infection from chewing child's food. 

Bataschoff 2 , lip. Boeck, W. 15 . Cold 2 . 

d. Infection from spoons, cups, etc. 

Bardinet (Did ay). Bertherand. Kobner 1 , pharynx (spoon). Lagneau, 
G. 4 (spoon). Loret, family epidemic (spoon). Lucas-Championniere 2 , family 
epidemic (spoon and cup). Monteggia 6 (spoon). Rollet 11 , tonsil (spoon). 
Roussel 2 ^, tonsil (spoon). Todd, throat (spoon). 

b. Infection of infant during feeding ; including, 1. Infection by a syphilitic 
attendant; and 2. Infection by children fostered with it. 

1. Infant infected by syphilitic attendant, through handfeeding. 

a. From tasting the nursing bottle. 

Anonymous c. Audoynaud 4 (Fournier). Ostroumoff*. 

b. From tasting and inserting the artificial teat. 

Plumert 5 . Polotenboff 3 (sucking-horn). 

c. From chewing infant's food. 

Boeck, W. 15 . Boettger. Chaboux 2 . Kilian 2 . Rosen von Rosenstein 2 . 
Wolf l . 

d. From warming its pap in the mouth. 
Van Deurs. 

e. From feeding with spoon or cup alternately with self. 

O'Connor 3 (spoon). Vidal-de-Cassis (tin cup). Wilson 3 , fauces (spoon). 

2. Infant infected from other infants fostered with it: (by common feeding- 
spoon, cup, sugar-bag). 

Sigmund. 



SYNOPSIS OF FACTS AND LITERATURE 225 

B. Infection by attendance on syphilitic infants (other than in connection 
with nutrition) : referring to, 1. Mediate contact; 2. Direct contact. 

1. Infant infected by mediate contact, chiefly from its attendant, in 
connection with its toilet, clothing, etc., relating to, i. Toilet articles; 
2. Coverings. 

1. Infection by toilet articles: including, a. Washwater; b. Sponges; c. 
Combs; d. Syringes. 

a. Washwater. 
Kobner 3 . 

b. Sponges. 

Chaumier, anus. Cullerier, A. 2 , vulva. Fournier 24 (Pontet 1 ), vulva. 
Hauner 5 , anus. Huguier 2 , pudenda. 

c. Combs. 
Pellizzari, P. (Pellizzari, C 9 ), scalp. 

d. Syringes. 

2. Infection by clothing, bedding, etc. 

a. Cloths, napkins, etc. 
Diday (Jullien 4 a), anus (towel or napkin). Lavergne and Perrin 6 , near 
anus. Pellizzari, C. 3 u2 , anus. Peter », vulva (diaper used as towel by 
father). 

b. Bedding, etc. 

Bolschwing 5 (cradle clothes). Cusack 4 (adult infected). Pellizzari, C. 22 , 
eyelid (pillow). Pellizzari, P. 2 , eyelid (pillow with saliva). 

2. Infection by direct contact, in care of children ; divided, as in Syphilis 
economica, into 1. Active; and 2. Passive contact. 

1. Infection by active and limited contact; divided into, a. Buccal; b. Digital; 
and c. Aerial. 

a. Infection by buccal contact, {lips, tongue, teeth): including, 1. Kissing and 
fondling ; and 2. Dental inoculation. 

1. Infection by contact in hissing and fondling, divided into a. Reciprocal; and 
b. Non-reciprocal. 

a. Reciprocal hissing, lip to lip. 

a. Adults infected from children. 

Boerhaave 1 (several women from one child). Davis. Eichman. Lee 3 , 
lip. Le Gendre 3 , tonsil (Hulot). Lydston 1 , lip. Musitanus (nuns in con- 
vent). Neumann h 7 , chin ». Pellizzari, C. 13 . Rollet 9 , lip. Stoll 3 . 

b. Children infected by adults. 

Baum 1 . Berlin 1 . Bryant 8 , lip. Capuron 8 , lip. Charrifre. Coote 1 . 
Dieterich, lip. Feulard 5 , lip. Fox, G. H. 1 , tongue. KObNer 4 . Koit, C. 2 . 
Lavergne and Perrin 5 . McCraith ', lip. Mireur. Neumann 1 . Payne*. 
Pellizzari, C. 12 Roger 2 , lip. Romanoff 1 . Stirling 3 , lip. Stoll. Szadlk 3 , 
tonsil. Taylor 7 . Tuholske, lip. 

16 



226 SYPHILIS INSONTIUM 

c. Children infected from children. 
Coote 2 . Griffin 3 . Gueniot (Pontet 2 ). Neumann 1 . 
b. Non-reciprocal kissing, lips to other parts. 

a. Adults infected. 

Egan 3 , neck (infant's lips to site of pin-scratch), 4 tongue (kissing about 
nates). 

b. Children infected. 

Breyer (Cunier 1 ), eyelid. Cunier 4 . Despagnet 2 , eyelid. Eltzina 2 , 
finger. Kudriashoff, penis. Mackay, eyelid. ' Ryan, J. P., forehead. 
Schurig. Thomas 2 , forehead. 

2. Infection by dental inoculation. 

Drysdale 2 , lip (bite of child). Snowball (Bird 1 , Ryan, C. S. 1 ), nose 
(bite of nursling). 

b. Infection by digital contact: including, i. Simple contact; 2. By nail 
wounds. 

1. Infection by simple contact (attendant or child infected). 

a. Adults receive chancre of finger. 

Schuller 1 , finger, 2 hand. Sigmund (a number of cases in old attendants). 
Ussas J , palm of hand. 

b. Infants infected by attendants. 

Baudry 1 , eyelid (saliva on attendant's finger), 2 eyelid (saliva on mother's 
finger). Bertin 2 , vulva (bathing with saliva by mother). Cullerier, M. 2 , lip 
(bathing with saliva). Leloir 4 , groin (from wetting with saliva). Pellizzari 
P. 2 , eyelid (saliva of mother). Sigmund 10 , mouth (by finger of midwife). 
Wecker 4 , eyelid (mother's saliva). 

c. Distal infection by own soiled fingers. 

d. Infection by child 'j soiled fingers. 

Biett 7 (Cazenave), lip (forcing secretion of mucous patches upon fingers 
into mouth of six-year-old brother). Fournier ( Pontet 3 ), tongue. Sturge 2 , 
lip, tongue. 

2. Infection by nail wounds. 

Denti, eyelid (in nurse from scratch of nursling). 

c. Aerial transmission by blowing or atomizing saliva. 

Solomon, J. V. 1 , eyelid (child infected by aunt, sputtering in the face). 

2. Infection by passive contact ; 1. In parturition; 2. During slumber; 3. By 
contact in arms, etc., as in Syphilis economica. 

I. Infection of infant from mother during parturition. 

Bell, B. 1 . Carreras-y-Arago, eyelid (?). Grunfeld 1 , scalp. Guibout. 
Poncelet. Thiry 6 . Weil \ nose. 



SYNOPSIS OF FACTS AND LITER A TURF 227 



2. Infection from contact in bed. 

Acton 4 . Bryant 9 . Colles 6 . Cooke 2 . Diemer. Friedlander 3 . 
Hauner 7 . Lesser 3 . Luzinsky 6 . Neumann 32 , umbilicus. Peatson. 

Pellizzari, C. 29 , inguino-scrotal fold. Pellizzari, P. 2 , eyelid. Swediaur 1 . 
Trousseau *, buttocks. Violet 1 , vulva. Voege. Waller 3 . 

3. Infectio7i from contact in carrying children; a. Attendant infected; b. Infant 
infected. 

a. Attendant infected. 

Cusack 3 , thumb. Dowse, forearm. Ford, shoulder. Hardy 5 , forearm. 
Hulot, eyelid. Keyes \ arm. Pacchiotti 5 , forearm. Pellizzari, C. 4 *- 2 , 
cheek. Soler 6 , arm. Waller 6 , cheek and neck. 

b. Infant infected. 

Hulot, neck (from nurse). Richet (Ricord 2 ) (contact with hand of nurse). 
Roger 3 . 

Miscellaneous instances of brephotrophic infection; a. Attendants infected; 
b. Infants infected. 

a. Adults infected by children. 

Baum 8 , chin. Boeck, C. 8 , tonsil. Boeck, W. t , lip. Breda 1 , tonsil. 
Broick 4 , palate. Bucholz, tonsil. Castelnau (Robert). Colles 3 . Cripps 2 , 
eyelid. Cusack 2 , peri-anal. Dantelssen 5 , tonsil. Dron 8 , lip, tonsil. 
Dusterdorf (case in epidemic) (Hufeland). Edlefsen. Fournier 53 , lip. 
Friedlander 4 , tongue 5 , 6 . Grigorow, tonsil. Gurovitch j , lip. Haslund 2 , 
tonsil. Hunter 3 . 4 . Hyde, thumb. Joly (case in epidemic). Jullien 1 . 
Kobner 7 , palate. Komin 3 , mouth. Lancereaux 3 . Lecoq 2 , tonsil. Lee, H. 1 , 
lip. Lemonnter. Lipp 3 , eyelid. Luzinsky 1 ,-, 3 , 5 . 6 . Mannino. Manssurow 1 , 
lip. Mentzel. Morgan 4 , mouth. Neumann ] , tongue. Pospelow s , tongue, 
12 fauces. Ricordi (cases in epidemics). Rinecker 1 . Rust 1 . Schirajew 3 , 
tonsil. Snell 2 , eyelid. Stark, tonsil. Tchistiakow 2 , throat. Thoma- 

SCHEWSKY 1 , tonsil. WlLDHAGEN 3 . 

b. Children infected by adults and by one another. 

Boeck, W. 7 , lip, "tongue. Bolschwing 6 (father syphilitic). Bulkley 
(mother syphilitic). Dantelssen 6 , mouth. Diemer 3 . Engelsted 6 . Feulard \ 
anus, 4 (Grancher) cheek. Fournier 23 , tongue, 46 (statistics in 42 cases: 19 
from parents, 8 from nurses, 4 from attendants, 2 from other children), 
Friedlander 10 , lip 11 . 12 . 13 . Garson (four children infected by parents) 
Guntz 14 . 17 . Hauner 2 . Henrot. Hjort 2 . Holm. Kayerin V 2 . Kobner 6 
Krowczynski 2 . Luzinsky ''-, 3 , W ; . Menard 2 . Moore 4 . Paul, lip. Pel 
lizzari, C. 1 . Peterson 1 . Popoff 3 . Rollet 3 , lip. Rosen von Rosenstein \ a 
Rupp >. Scarenzio 2 > 3 » 4 . Secheyron K Sturgis 2 , eyelid, 3 cheek. Tchis 
tiakow 4 , forehead. Trousseau 4 . Vere-Delisle, anus. Wallace '. Wal- 
ler 1 , 2 , 4 » 5, 7 . 



228 SYPHILIS INSONTIUM 

III. SYPHILIS TECHNICA. 

This section, relating to the acquiring of syphilis in connection with body- 
service, has three great divisions : A. Where the operator becomes the victim 
of syphilitic inoculation ; B. Where the operator, being syphilitic, conveys his 
own disease to others, in body-service ; and C. Where the operator, or his 
instruments, serves as the medium of syphilitic inoculation, from one patient 
to another. 

A. Operator the victim: i. From unnecessary exposure ; 2. From neces- 
sary exposure. 

1. Infection from unnecessary exposure: a. In performing surgical 
operations ; b. In making post-mortem examinations. 

a. Operative, received in course of surgical operations. 

Abernethy 2 , finger. Auspitz (Zeissl, H« 13 ), self, finger. Brush, thumb. 
BulkleYo Bumstead 7 , finger. Cavazzani 2 , finger. Cazenave 3 . Coote 3 , 4 , 
self, finger. Delpeche 1 (Lawrence j ), finger. Galvin, finger. Hardie, finger. 
Lydston 2 , finger (case of Dr. Nott). Otis 2 , finger. Pellizzari, C. 25 , finger. 
Scarenzio e , self. Schnitzler, finger. Wilks, finger. Williams, A., finger 
(operation of fistula in a horse ? ). 

b. Cadaveric, from post-mortem examinations. 

Hourmann (Lagneau, G. 2 , Cazenave, Vidal-de-Cassis). Howard, hand. 
Morgagni. Paulini (pulverized bone). Rumpf 3 (Vogel). Sommering. Swe- 
diaur 2 . Taylor 20 . 

2. Infection from necessary professional exposure; a. Manual infection; 
b. Cephalic infection. 

a. Manual (digital) infection ; chiefly -from exploration of cavities, etc. ; 
a. Surgeons; b. Accoucheurs and Midwives; c. Dentists; d. Attendants. 

a. Infection of surgeons, in manipulative procedures. 

Arthur 8 , finger. Augagneur 2 , finger. Bell, B. 1 . Bloom 5 , finger, 6 thumb. 
Brandis, finger. Broick 2 , finger. Bulkley. Buret 3 , back (auto-inoculated 
by finger). Cairns, finger. Churchill, thumb. Coesfeld, finger. Cooper, 
S., finger. Gascoyen, thumb. Goodell 1 , finger. Gross 2 . Guntz 4 . Holt- 
house, finger. 'Jullien 13 , finger. Jumon 3 (Fournier), hand. Lawrence 2 , 
thumb. Lee, H. 2 , 9 ] - 2 , finger. Mason 5 , finger. Morgan 5 , finger. Ory 4 , 
finger. Otis L 7 , finger. Paget, J. 2 , finger 3 . Pancritius 1 , finger. Pelliz- 
zari, C. 24 . Poray-Koschitz 25 , thumb, 26 hand. Ricord 6 , finger. Rosenthal 1 
(Lewin), hand. Rumpf 2 , hand (Pierson). Sigmund 4 , finger. Sims 1 , finger. 
Swediaur 2 . Symonds, finger. Tail, finger. Taylor 23 , finger. White, J. 
C.* Zeissl, H. 2 , arm. 

b. Infection of accoucheurs and midwives. 

Anonymous h, finger 15 . Atkinson 3 , thumb. Bardinet 6 . 7 . Bayer. 
Bell, B. 1 . Bernard, A. 4 , finger. Biett 6 . Borgarutius, finger. Boudinet, 
finger. Bourgeois. Brambilla, finger. Broick 2 , finger, 9 finger. Campana 2 



SYNOPSIS OF FACTS AND LITERATURE 229 

(Mayer). Cazenave 4 > 5 (Biett). Clowes l (Lee, H.) ". Cohansen. Cohn. 
Dawosky ] , finger. Denis-Dumont 2 , finger. Devaux 1 , finger. Engelsted 1 , 
finger. Fernelius 3 , finger. Fuchs 2 . Galligo 3 . Gallus (Lecoq). Gardane 1 . 
Glatter, arm. Goodell 2 , finger 3 . Guntz 3 , 15 . Hamerton 3 , palm of hand. 
Hardy 3 (Ory) 12 . Hutchinson 2 , thumb. Kobner 9 , finger. Kopp, J. H. 
Lawrence 3 . Minkevitch, finger. Neumann 3 , hand. Palfyn. Pellizzari, 
C. 23 , hand (of P. Pellizzari). Pettman, finger. Pick 1 , finger. Plumert 6 , 
thumb. Pospelow 2 , finger. Protzek, finger. Riedlin. Saulsay, finger. 
Schubert 2 . Sigmund 9 , finger. Simon 1 . Suchanek 3 , finger. Swediaur 2 . 
Taylor 25 , finger. Wedekind. Wendt \ finger. White, J. C. 2 , finger. 
Wolff (Weiger), finger. 

c. Infection of dentists. 

Anonymous d, finger. Bumstead 3 . Fournter (Lesage 5 ). Hutchinson. 
Neumann 8 , finger. Taylor 11 . 

d. Infection of attendants, students, etc. 

Bronson 2 , thigh. Burtzeff, hand. Diemer 4 . Kaposi 3 , finger. Leloir 2 . 
Thomaschewsky 3 , tonsil. Vyshogrod, finger. Zeissl, H. 6 , finger. 

b. Cephalic infection; including 1. Buccal; 2. Facial. 

1. Buccal Infection ; a. By breast-drawing ; b. By wound-sucking; c. By 
inflation of lungs of new-born ; d. By applying tongue to eye. 

a. Infection from breast-drawing. 

Alberti. Barry. Bigelow 2 * 3 , throat (Durkee 3 ). Bilguer (Rosen von 
Rosenstein). Bourgogne j (Fournier). Canetta. Everardus. Hamerton 2 , 
lip. Heinecken. Hey, lip. Joly (Seutin). Lawrence 6 , lip. Leloir 6 , lip 7 . 
Leo. Loder 2 . Marone 2 , lip and tongue. Munninks. Ricordi *. Rupp 3 , 
fauces. Viennois l . 

b. Infection from wound-sucking. 
Leloir. 

c. Infection from inflating lungs of new-born. 

WlGGLESWORTH », tonsil. 

d. Infection from applying tongue to eye. 

(In many of the instances quoted on page 231, the operator had first 
acquired chancre of the tongue in the practice referred to). 

2. Facial infection; a. By own fingers; b. By direct contact; c. By aerial 
transmission. 

a. Infection by ownflugers, etc. 

Anonymous g, eyelid. Binet 2 , cornea. Bouciieron 2 , eyelid. Buret 2 , 
eyelid. Campart 2 , eyelid. Dki. Montk '» 2 , eyelid (Sbordone). Desmarres 2 , 
eyelid. Dietlen, eyelid (Michel). Esof (amniotic fluid). Hardy 7 , eyelid, 
nostril, lip. Hutchinson, lip (inoculation of a scratch). Mek.iian 2 , eyelid. 
Mason, lip. Rasori 2 , nostril. Ricord 7 , cheek. Stanley, lip. Tarnovvsky 4 
(amniotic fluid). Vvedensky 2 , temple. Watson, S. 3 , nostril. 



230 SYPHILIS INSONTIUM 

b. Infection by direct contact. 
Wendt 3 , cheek. 

c. Infection by aerial transmission, coughing in the face, etc. 

Alexander 2 , eyelid. Desmarres l (Michel 4 ), eyelid. Fournier 15 (Saw), 
eyelid. Hardy 6 , eyelid. Leloir 9 , face. 

B. Operator the syphilifer ; 1. Infection by direct contact; 2. Infection 
by instrumental contact. 

1. Infection by direct contact, without the intervention of instru- 
ments : including, a. Digital contact ; b. Buccal contact. 

a. Infection by digital contact; a. Infecting finger seat of a chancre; 
b. Infecting finger soiled by saliva, etc. 

a. Infecting finger seat of a syphilitic primary lesion ; 1. Chirurgical manipula- 
tions ; 2. Obstetrical manipulations. 

1. Infection by chirurgical manipulations. 

a. Vaginal, anal, and other examinations. 

Coste (in Berlin), rectum, Hutchinson, anus (examination for hemor- 
rhoids). 

2. Infection by obstetrical manipulations ; a. Mother infected ; b. Infant infected. 

a. Mother infected by accoucheur' 's hands. 

Anonymous 15 . Dawosky 2 . Fournier 51 , 56 . Hutchinson 24 . Leloir 17 . 
Mauriac 12 . 

(See also Epidemics, Accouchment). 

b. New-born infected by accoucheurs hands. 

Bardinet 6 (Some of the children showed syphilis before their mothers, 
in the epidemic of Brive). 

b. Infecting finger soiled with saliva of operator. 

a. Obstetrical iufection. 

Bleynie (Bardinet 7 ) (A midwife infects a number of children by apply- 
ing her saliva on her finger as a haemostatic to the stump of the divided cord). 

b. Medical and surgical infection. 

Anonymous p (Clossius 2 ) (a woman who was a sort of lay practitioner 
infects a patient in " raising the uvula " which had probably been "swallowed." 
Broick 7 , nose (application of saliva to an erysipelas). Krelling 2 , nose 
(application of saliva to heal an erysipelas). 

b. Infection by buccal contact; 1. With a tround ; 2. Without an open wound. 

1. Buccal infection through an open wound; a. In wound-sucking; b. In 
circumcision. 



SYNOPSIS OF FACTS AXD LITERATURE 231 

a. Infection by wound-sucking. 
Anderson, cheek. Fournier (Jumon 1 ), calf of leg. Hill 1 , cheek. 
Meighan 1 , eyelid. Robbins \ hand. Van Harllngen i:i , eyelid. 
b. Infection in circumcisioii. 
Albers 1 . Bierkowski. Jaffe. Kedetoff. Kosinski. Lubelski. 
Mattlakowski. Multanowski. Xowakowski. Robbins 2 . Rust. Solomon 
(in Hamburgh). Taylor l . Wendt 2 . 

(See last section, and also Epidemics.) 

2. Infection without an open wottnd; a. In breast-drawing; b. In remov- 
ing foreign particles from the eye, by the tongue. 

a. Infection by breast-drawing. 

Alberti. Barry. Bilguer (Rosen yon Rosenstein). Bloch. Bourgogne 1 
(Fournier). Canetta. Eyerardus. Gailleton (Roussel). Heinecken. Hey. 
Joly. Kyll. Lanzoni. Leloir 7 . Leo. Loder 2 . Munntnks. Parker 1 . 
Ricord 11 . Ricordi \ Rollet-. Sydoyv Taylor 10 . Winslow. 

b. Infection by application of tongue to the eye, to remove foreign bodies, etc. 

Andrews, eyelid. Buch, eyelid. Edes, eyelid. Galezowski 6 , eyelid. 
( 7 Layergne and Perrin), eyelid. Lee, C. G. , eyelid. Montgomery, conjunc- 
tiva. Murzin, eyelid (to cure stye). Pospelow 1T , eyelid. Szokalski, con- 
junctiva. Tepliaschin (Langlebert 4 ). 

2. Infection by instrumental contact (instruments soiled with operator's 
saliva), a. By tattooing needle ; b. By cupping instruments. 

a. Infection by tattooing; needle or pigme7it moistened with i7ifected saliva. 

Arthur- (Wilcox). Barker, F. R. Carleton. Hutin. Josias. 
Leckie and Carlton. Maury and Dulles. Moffet ] , 2 , 3 . Petry. Porter, R. 
Robert. Robinson, F. Rollet. Stirling- 4 . Tardieu. Trotter. 
Viennois c . Whitehead. 

b. Infection by cupping. 

In several of the Finnish epidemics it is stated that the cupper (a woman) 
was syphilitic — once at least that the disease was professionally received — and 
that the transmission was by means of saliva on the finger, used each time to 
clean the cup, etc., before using. 

Hardh, J. O. Hjelt W ! . Resiiktmkoff, neck. Spoof. 

c. Operator the medium; 1. By transplantation and inoculation; 2. By 
unclean instruments; 3. By unclean substances. 

1. Infection by transplantation and inoculation; i. Of solid sub 
stances; 2. Of liquid substances. 

1. Infection by transplantation of solid substances; a. Of teeth ; b. Skin grafting. 
a. Infection by transplantation of teeth. 

Hamilton 1 . (Lettsom 2 ). Hunter 5 . Ki'tin (Lettsom- 1 ). Lettsom 1 . 
Watson, W. (Hunter, Swediaur). 

Besides the above, FRANK, J. a Merkel, and others less known, wrote on the 
subject. 



232 SYPHILIS INSONTIUM 

b. Infection by skin grafting. 
Deubel (Fereol). 

2. Infection by inoculation of liquid substances ; a. Vaccination ; b. Variolation ; 
c. Syphilization. 

a. Infection from vaccination. 

Adelasio 2 . Amoroso. Auxias-Turenne 2 > 3 , 4 . Bardinet 8 (Depaul). 
Bohn. Boudais. Caillard. Carter, R. B. Ceccaldi. Cerioli 3 . Chas- 
saignac. Cheadle l . Clement (in Frankfurt). Cory (Hutchinson 22 ). 
Coste (in Paris). Crawford. Creighton. Demaux (Laroyenne x ). Depaul 

2 , 3 . 4 (ZALLONIS 5 ), (VlCHERAT 6 ). DEVERGIE. DrYSDALE '. EULENBERG 1 ' 3 . FEU- 

lard 1 . Foster 1 . Fournier 46 , 51 > 56 > 62 > 63 > 64 > 65 . Frankel. Frezoul. Fried- 
lander 2 (?). Gautier. Guevin \ Hauff. Haydon. Herard ». Hervieux 

(?). HERZENSTEIN 2 . (TCHORZNICKI, TCHISTIAKOFF, VUKOLOFF). HOUGHTON. 

Hutchinson, J. 4 , 8 , 10 , » (Tay), 12 , )3 , 14 , 15 . Kobner 12 , 13 . Korver. Lang 5 . 
Langenbeck, B. von. Lanoix 2 . Laugier. Lecoq ] (Guyenot). Lee, H. 9 . 
Leppmann. Lever. Lodge (?). Lotz. Mason 8 . Middleton l . Monell. 
Morax (Bouvier 2 ). Moseley. Nayler ] > 2 . Ollier (Bouilly 1 ). Orlandini. 
Parola. Passant. Pellizzari, C. 17 . Perrin 2 (Zuriaga). Pitton. Pol- 
lock. POPOFF 2 . PORAY-KOSCHITZ ' 2l > 22 . POUMEAU-DELILLE. PrETTYMAN. 
RlCORD 21 . RlCORDI 3 . RlNECKER 2 . ROBERT, M. 3 . ROBERT, P. ROBINSON, 

E. (?). Rodet 2 . Rosenthal 2 . Salsotto 2 . Scott (Purdon). Sebastian 

(Blot). Smith, T. Solomon, J. V. 3 Startin 1 , 2 (Nayler). Trousseau 3 

(Sistach). Vanmerris. Viani. Vidal (Ory 3 ). Whitehead (in Manchester). 

(See also Epidemics, 7 vaccination, p. 210). 

b. Infection by inoculation of variolus pus. 

(Introduced into Europe in 1721, it is said by Depaul to have been 
accused of transmitting syphilis —no references nor cases given). 

c. Infection from the so-called syphilization. 

(In performing auto-inoculation for the purpose of so-called syphilization, 
as a cure, it has occurred that patients who previously had only chancroids 
became inoculated with syphilis). 

Lee, H. 12 j - 2 (Danielssen). 

2. Infection by means of instruments soiled by previous use. a. By- 
cutting instruments ; b. By blunt instruments. 

a. Infection by sharp or cutting instruments; I. Wound accidental ; 2. Wound 
intentional. 

1. Infection by accidental wounds with sharp instruments ; a. By dental instru- 
ments ; b. By razor wounds. 

a. Infection in %vounds by dental instruments. 

Barclay, lip. Bulkley 4 , tongue. Dulles 2 , lip. Giovannini'-, lip. 
Lancereaux 8 , gum. Leloir 15 , gum. Lydston 4 , gum. Otis 5 , angle of 
mouth. Pease 2 . Roddick 6 , gum. 



SYNOPSIS OF FACTS AND LITERATURE 233 

b. Infection in razor wounds. 

Agasaroff. Allen 2 , cheek. Anonymous 16 . Albert 3 chin. Bovero. 
Broick », chin. Brousse. Bllkley. Carre (Martin 4 ). Cheminade ] , neck. 
Choclow 1 , cheek. Chudnqski", chin. Cripps 3 , chin. Delpeche 2 , chin. 
Despres (Cochez), chin. Fedchenko-, chin. Feibes, cheek. Fleischer, chin. 
Fournier 37 , chin (Dubreltlh in Paris, Zwetitch, Morel-Lav allee 5 ). Gio- 
vannini 6 , cheek. GlCck 3 (naso-labial fold). Goldenberg 4 , cheek. Henry 1 , 
lip. Idelson, chin. Koltschewski, chin. Ladroire-Yver, cheek. Mauriac 6 , 
lip, cheek. Morel-Layallee 5 , cheek. Morrow 1 , chin. Neumann 25 , chin. 
Nikolski, D. P. 1 , angle of jaw. Oestreicher, cheek. Pellizzari, C, (in- 
clined to accuse lather brush). Penny 1 , lip. Robbins 3 . Tarnowsky 1 , chin. 
Taylor 13 , chin 20 . Tchudnowsky, chin. Tzitrin. Vallauri. Van Har- 
lingen 8 , face. Viguier 9 , chin. Windheuser, chin. 

2. Infection by intentional wounds ; a. In phlebotomy ; b. In minor surgery ; 
c. In wet cupping ; d. In leech bites ; e. In tattooing (needles infected from 
previous subject); /. In vaccination wound (soiled instruments). 

a. Infection in phlebotomy. 

Bell, B. 1 Bonorden. Daguerre (Cazenave 8 ). Lebenwald. Ricord 3 
(Acton l ). 

b. Infection in scarification and other minor operations. 

Bassereau 4 (Jumon 2 ). Behrend 5 . Diemer 2 . Fournier 9 . Fritze. Ho- 
molle, scrotum. Kobner 10 , axilla (cutting furuncle), n scrotum (scarifying). 
Lang 1 , forehead (opening furuncle). Maes, eyelid (incision of stye). Robin- 
son ', penis (phymosis operation). Sperino 2 . Swediaur 3 . 

c. Infection in wet-cupping. 

Cornarius. Geigel ] . Hornung (Lammert). Horst 2 , 3 (Snitzer). Jor- 
danus. Lammert 1 . Meyer-Ahrens. Poliataieff. Rona 6 . Widmann 
(Horst 4 ). 

d. Infection in leech bites. 

Anonymous 14 . Steinbacii, temple. 

e. Lifection in tattooing (needles infected from previous subject). 
Poilroux (Geigel 2 ). 

/. Infection in vaccination wound (soiled instruments, etc.). 
Bonniere. Bourdon (Ory 2 ). Jenkins. Lorain. Taylor 6 . 

b. Infection by blunt instruments; a. Eustachian catheters; b. Probes, 
sounds, catheters and specula; c Serres-fines, porte-caustiques, etc.; d. 
Tongue spatulas ; e. Syringes. 



234 SYPHILIS INSONTIUM 

a. Infection by Eustachian-sounds and catheters, 

Belhomme and Martin 3 . Blauchet. Bousquet. Brouardel 1 , 2 (Bucquoy 1 , 
Cullerier). Bucquoy 2 (Danyon, Cullerier). Burow. Cohen. Cou- 
tagne, tonsils. Cozzolino 2 , nose. Diday 9 . Fournie, pharynx. Fournier 5 , 
tonsil 6 > 10 > 45 > 51 > 56 . Gosselin 3 (Jullien 7 ). Gubler 2 (Soucher), 3 (Ricord). 
Hardy 2 , tonsil. Hillairet h 2 » 3 . Laboulbene l . Lailler ', nostril and 
throat. Lancereaux ' (Besanqon 7 ). Le Gendre 7 , tonsil. Lortet. Moure 2 
(Dupond 1 ). Muller. Pujol. Raynaud (Lancereaux »). Secheyron 2 (?). 
Seweke, tonsil. Solis-Cohen. Tardieu 5 (Ricord). Vadja 2 . Vigla. 
Zeissl, H. 3 , fauces. Zewecke, tonsil. 

b. Infection by probes, sounds, catheters and specula. 

Tardieu 3 (vaginal speculum). 

c. Infection by serres-fnes, porte-caustiques, etc. 

Del Greco (Pellizzari, C. 20 ), leg (from brush electrode). Fournier (Tar- 
dieu 4 ) (serres-fines). Leloir ]6 , finger (porte-caustique). Taylor 20 , (caustic 
holder). 

d. Infection by tongue spatulas, laryngoscopes, etc. 

Jumon 4 (tongue spatula, physician infected himself), (Fournier). 
Taylor 20 (tongue scraper). 

e. Infected by syringes {^vaginal). 

Fournier. Jullien 2 . Leloir 1 ' 2 . 

3. Infection by means of unclean substances ; 1. In suspension ; 2. On 
bandages, lint, etc. 

1. Infection by virus in suspension ; a. In wash-water ; b. Local therapeutics. 

a. Infection by wash-water. 
Moty, eyelid. Neumann 28 , ala nasi. 

b. Infection in connection with local therapeutics. 

Castel du\ arms (in treatment for scabies). Fournier 67 , penis (scratch- 
ing in scabies), 69 (Feulard) ' 2 , arm (treatment for scabies). Lailler 2 , penis and 
scrotum (treatment for scabies). Pollaesik (after scabies). Profeta 7 , between 
fingers (in scabies). Rona 3 , forehead (in eczema; hospital infection). 

2. Infection by virus on bandages, lint, plaster, etc.; a. In surgical dressings; 
b. In circumcision. 

a. Infection in connection zuith surgical dressings. 

Bernard, P., arm. Hutchinson, j. Jr.', occiput, 2 heel. Sigmund 8 , neck 
and shoulder. 



SYNOPSIS OF FACTS AND LITERATURE 



235 



b. Infection through lint, etc., in connection with circumcision (many unexplained 
cases are inserted here). 

Biett 1 (Albers 1 ). Brecker (Jaffe). Fischer (Jaffe). Goldenberg 2 . 
Jaffe. Kaposi 2 . Kessler. Klein 2 . Kotzyn. Lewentauer. Lubelski-. 
Obalinski (Jaffe). Poray-Koschitz 6 . Rollet (statement of the probable 
presence of circumcision syphilis in the Mahometan races of North Africa). 
Segel (Jaffe). Sonsino. Taylor 1 . Vaxier. 

(See also Epidemics, 6 circumcision, p. 210). 

Note : As there are names in literature whose cases cannot be discovered, 
so there are vague references to places, the seat of epidemics for whom no 
authors can be found. Jaffe speaks of cases at Vilna, Warsaw, and Lemberg, 
soon after the episodes of Rust and Wendt. Leppmax (1883) of one recently 
present at Neisse, in Silesia, and one in the suburbs of Paris in 1867. 



SUPPLEMENTARY INDEX. 

Reported cases (hot included in preceding) where location is stated, but 
not the mode of infection ; also statistical reports. 

Cephalic. 

Arcari 3 . Caby (Fourxier). - del Chiappa 4 (multiple). Dubreuilh in 
Bordeaux (Bracquehave) (multiple). DuPoxt. Kiliax ' (multiple). Lalle- 
maxd 3 . Pacchiotti 3 (multiple). Stourme. Thiry 1 (Spaack). 



Scalp. 



Gluck 2 . Kaposi 6 . Lloyd 3 . 



Forehead. 



Paliard. Pauly 2 . Poray-Koschitz 18 . Ricord 8 . Trivet (Fournier). 

Eyelid and Conjunctiva. 

Adams, J. E. (Alexander). Arlt (Wiethe 2 ). Astruc 2 . Albert 4 
(Stolrme). Badal 1 . 2 . Barthelemy 2 (Fournier). Baudon. Bernard, E. 
Brinchen. Brocq ' (Parinald 2 ), (Besnter). Broick 6 (Krellixg '). Bllklev - { h. 
Bull. .Bumstead 6 . Campart '» 3 i 4 . Castelo. Claeys. Clerval. Closa. 
Cooper, J. F. Critchett. Clllerier, A. 3 > * (Mackenzie, W. 1 ). Clxier 3 . 
Dardel (Clerc). Delapersonne 3 (Barthelemy *). Demets. Desmarres 3 . 
Despagnet '. De Vincentiis (Profeta). Dixon. Doe (De Beck). Dubreuil. 
Dulles 3 . Fano 2 (Touchaleaume). Fenwick (Cline). Fernandez. Fienzal. 
Fitzgerald. Fonseca. Forti mauls. Galezowski 3 , 4 . Gay, A. H. 3 . 

GlOVANNINI 8 . GOLDENBERG 3 . GosSELIN 2 (GlIGNARD c ). GRAIL. GRANDMOND. 

Gratia 3 . Griffith. Gubler l (Ricord 13 ). Hairion (Cunier 2 ). Hock 



236 



SYPHILIS INSONTIUM 



(Boeck). Holmes 1 . 2 . Horand (Jullien). Horteloup, P. 1 . Huguier 1 . 
Hutchinson, J. 6 , 23 . Juler (DeBeck 3 ). Knapp. Laskiewiez. Lavergne 
and Perrin 3 . Lawrence 7 . Lawson. Leber (De Beck). Lesser 4 (Krel- 
ling x ). Lipp 2 . Loring' 1 (Sturgis 2 ). Lurinsky \ 2 . Mackenzie, W. 1 
(Michel 2 ). Mason 4 (Lee, H.). Mastin. Mauriac n . Michel 6 (Ricord). 
Mittasch. Moura. Nagel (De Beck). Nelaton (Laroyenne 2 ). Nettle- 
ship 2 . Neumann 23 . Neves-da-Rocha. Noyes. Ottava. Panas (Delaper- 
sonne h 2 ). Pfluger h 2 . Pospelow 15 . Randall (De Beck). Ricord 9 > 13 i 20 . 
Ring. Robert, M. 2 . Rollet 13 . Rona 5 . Sabolotsky. St. Martin. 
Seeley (De Beck). Serdukov >. Smith, W. P. Streatfield ^ 2 (De Beck). 
Thiry 2 . Ussas 5 . Valentine. Viguier 1 . Watson, S. 4 . Wecker j (Michel 5 ). 
Wherry. Wiethe ' (wound in dance). Wolfe. Zeissl, H. 7 . 



Ear. 



bulkley 3 j. 
Rasori \ 



Cullerier, M. 4 . Guranowski, middle of ear. Jullien 5 . 



Cheek. 



Atkinson 2 . Barthelemy 3 (Zwetitch 3 ). Bulkley 3 ^ Caramitti 3 . Clem- 
ent in Lyons. De Amicis 5 . During 1 . Farriols. Fedchenko 3 . Fournier 50 . 
Friedlander 14 . Gay, A. H. 3 . Giovannini 6 . Gould. Guignard 2 (Vincente). 
Hutchinson, J. 36 . Kaposi 7 . Leprovost (Horteloup). • Loring 2 (Sturgis 3 ). 
Marey (Fournier). Marianelli 1 . Mitchell. Monnet K Pauly l , 2 . Poore. 
Rollet 16 . Roussel 8 (Aubert). Sheild 2 . Stukowenkow 2 . Treves 
(White, J. W.). 

Nose and nares. 



Aubert 2 (Stourme). Baumes 3 (Ricord). Bierchen 1 (Rosen v. Rosen 
stein). Biett 8 (Martins, Ricord). Bird 2 . Bonnet (Rollet 14 ). Boulangier 

BULKLEY 31 . CARAMITTI 2 . COOPER '. CUTTER. FOURNIER 32 . FrOELICH 2 

Gay, A. H. 3 Gemy '. Gibier-de-Savigny. Gosselin 1 (Dulac). Gueyin 
Jullien 9 (Hillairet), 10 (Lailler). Laurent. MacCarthy. Morel-Lavallee 
(Fournier). Morrow. Moure 4 . Nettleship ] . Neumann 21 *. Poncet 1 
Prewitt. Quinquaud and Nicolle 6 , also temple. Ryan, C. S. 1 (Bird l , Snow 
ball). Viguier 3 . 

Lip. 



Adams, J. 2 . Allen 1 * 3 > 5 . Anonymous U k. Aubert 1 (Stourme). 
Barduzzi 2 . Baum 3 , 5 . Bayle. Besnier 1 , 2 t>, 2 c (Horteloup) 4 . Bierchen 2 
(Rosen v. Rosenstein). Bjorken 3 . Blair 1 . Blanc 1 . Bloom 4 . Bloxam. 
Boeck, W. 12 . Bourcy (Mauriac). Boys-de-Loury and Casthilhes. Broca 
(Fournier). Broick 1 . 8 . Bryant 1 . 2 . 3 . BuLKLEY 3 a. Buret 1 (Soler y 
Buscalla). Buzenet 1 . Calvo. Caramitti. Cayla. Cazenave 1 (Biett). 
Cehak. Cenas ] (Stourme). Chartier. Chauvet (Ballet). del Chi- 



appa 2 . 3 . Chiari 1 . Clarke, B. Cooke 1 (Mason). Coote 



Corcelet 



(Diday). Cordier (Stourme). Couper. Cullerier, A. 7 . Cunier a . 
Demange. Dickinson. Diday S c (Gorcelet) 7 > s , (Bodet) i2 . Dolbeau. 



SYNOPSIS OF FACTS AXD LITERATURE 237 

Dubois, H. Dubois, P. During 1 . Fano 1 . Farlow. Finger 1 (Zeissl, H. 10 ). 
Fisher. Fournier 3 * 4 , », 32 , 42 , 60 . Fox, G. H. 3 . Froelich 2 , 3 . Gamberini 5 . 
Garreau. Gaudichier. Gay, A. H. 3 . Gemy. Gilbert 4 . Giovannini 1 . Gue- 

YIN 2 . GUIBOUT 2 (ZWETITCH 1 ). GuiNAND 3 , 6 . GuNTZ 2 * 8 , n . GuTTCEIT. HARDY 4 

(Ory 11 ). Harsant. Henry 2 . Heurtaux. Heylen-de-Herenthals. Hulke. 
Hutchinson 16 , 21 , 34 . Kaposi 8 . KortCm 1 . Labbe (Ory 13 ). Lacroze. Lang 3 , 4 . 
Langlebert 5 . Lefort (Jullien). Leonard. Lesser 2 . Lewix 7 . ,n i ". 
Lewy and Goldberg 1 . 4 < 5 , 6 , 10 . Lindstrom 1 . Lindwurm. Lipp 1 . Lorut 
(Fournier). Lucas. MacCarthy. McGuire. Marianelli 3 . Mason 1 (Wat- 
son, S. 2 ). Maunder *. Mauriac ] , 5 . Massarosh. Mikulicz and Michelson. 
Millard 2 (Budor). Moffat. Monnet 2 . Moore 2 . Morel-Layallee 4 (Four- 
nier). Morozoff. Morpian. Nassans (Fournier). Nasse l (Ruthenbfrg). 
Neumann 2 , 12 i 13 > and nose 14 . Nunn 1 . Ory j (Besnier) 15 (Lailler). Owen. 
Pajet, J.' 2 . Pancritius 4 . Pauly 1 . Pellizzari, C. 27 . Pellizzari, P. 4 . 
Perroud 1 , 3 . Petersen 9 . Pick 2 . Piogey (Arnal). Plumert 4 . Poisson 1 . 

PORAY-KOSCHITZ 9 , 1! ) l2 , 14 , 2T ) 2S . PoSPELOW 9 . PoSSELT (WALTER 4 ). PrOTO- 

popoff. Proust (Chauyet). Quain. Quinquaud andNicoLLE 1 . Rabinovitch. 
Rayogli and Rasori 1 . Redner. Regoby 2 (Martineau). Reichebach 1 . 
Ricord 10 , 17 . Rizat 2 . Rodet ] (Diday). Roussel 3 . Rumpf ] , 4 . Sarda 
(Chrestien 4 ). Serdukov 4 . Sherwell 1 . Sigmund 1 , 2 , 16 > 17 . Soler 1 . Som- 

MERBRODT (CHIARI 2 ). SpERANSKY 2 . STANCH. STIRLING 2 . STRAUSS. STURGIS 4 . 
TARNOWSKY 2 . TcHAGIN 1 , 2 . TCHISTIAKOW 10 » »i 13 > 17 , 19 . TOUJAN 1 . ToURNER. 

Trevisanello 2 . Turner. Vadja 1 . Van Harlingen 5 . Viguier 3 , 5 . Ville- 
neuve. Waller 10 . Wildhagen l . Woillez 1 (Ory). Zeissl, H. 1 , ». 
Zeleneff 2 . 

Chin. 

Augagneur 1 (Stourme). Barduzzi 1 . Baum 9 . Beyran. Bulkley 3 s. 
del Chiappa 1 . Cooper, A. 5 . De Amicis 6 , also nipple. Fournier 39 . Gam- 
berini 3 . Gay, A. H. 3 . Giovannini 5 . Ladriet-de-Lacharriere. MacCarthy. 
Marianelli 3 . Mauriac 1 , 10 . Mr.ac.ek 3 . Ory l (Besnier). Pellizzari, C. ]v S 19 . 
Plumert 5 . Quinquaud 7 . Regoby l (Tillaux). Rizat 3 . Taylor 17 . Trelat. 
Zeissl, H. 4 . Zwetitch 2 (Fournier). 

Neck, 

Fedchenko 1 . Fournier 17 , 50 . Hermet (Fournier 43 ). Langlebert 6 . Le 
Gendre 10 (Fournier, Hulot). Viguier 10 , ». 

Throat. 

Aubert 5 (Stourme). Belousow 5 , 6 , 10 . Besnier 1 . Cavazzani 1 . Cul- 
lerier, M. 5 , 6 . Daxielssex s . Dufour (Fournier). Fournier 32 , 41 . Gay, A. II.' 
Krisiiaber. Lagxeau, L. V. Lewy and Goldberg 2 . Moure 5 (Dupond). 
Oesterlen. Ory 9 (Vidal). Poray-Kosciiitz 4 , 31 , 3 ' 2 . Pospelow ", 14 . Spe- 
raxsky 3 , 4 . 

Buccal cavity. 

Belousow 7 , R , 12 . Cexas 2 (Stourme). Fournier •V v V , \ Fox, G. II.'. 
Guibout 4 . Jakoleff 3 . Lloyd 1 Lorenzo. MoNNET 3 . Poray-Koschitz ». 
Sheild '. Van Harlingen 3 . 



238 SYPHILIS INSONTIUM 

Guru. 

Cayla 2 . Cordier (Stourme). Fox, G. H. 2 . Gilleeert. Kinsman. Mac- 
Carthy. Poncet 2 . Salsotto 4 . 

Palate — hard and soft. 

Anonymous]'. Astruc 1 . Aubert 6 (Stourme). Barthelemy 1 (Le Gendre 14 ). 
Belousow 9 . Lancereaux 5 . Lewi 4 . Neumann 26 . Tchistiakoff 16 . 

Tonsil. 

Allen 6 . Anger, B. (Morel-Lav allee ] ), (Le Gendre 11 ). Anger, Th. (Le 
Gendre 3 , Brocq 3 ). Belousow 11 . Boeck, C. 2 , 3 > 7 > 10 . Borovsky 1 . 2 . Broick 10 . 
Bulkley 3 d. Bumstead 1 (Knight' 2 ). Colombini. Cordier (Stourme). Cul- 
lerier, A. 5 (Le Gendre). DeMeric. Diday 3 , 13 . Donaldson. Duguet (Le 
Gendre 8 , Lannois). During 2 . Favier. Foster 2 (Fox, G. H. 6 ). Fournier 34 
(Guignard 8 ). Gauducheau. Gay, A. H. 1 . Gibert 5 (Putegnat). Gilles-de- 
LA-TouRETTEandHuDELo. Glauert. Goodell 4 . Guibout 3 (Le Gendre 11 ) 
Haslund 4 , 5 ). Hutchinson, J. 2n . Inell (Malm 2 ). Jadassohn. Jakinovitch 
Laboulbene 2 (Le Gendre 2 ). Le Gendre 4 (Merklen) 9 , 10 > 13 (Fournier, Hulot) 15 
(Mauriac, Rizat). Letnik. Lewy and Goldbergs u . Lindstrom 3 . Malm 1 , 3 
Martel (Le Gendre 5 ). Martelliere 1 , 2 . Mauriac 8 . Molenes. Neumann 18 , 27 
Ohmann-Dumesnil 3 . Pean (Hue, Le Gendre 6 ). Pellizzari P. 3 . Petersen 5 

PlRANDRAN. POLOTEBNOFF 8 . PORAY-KoSCHITZ 16 . QuiNQUAUD and NlCOLLE 3 

Rabitsch. Razumoff 2 . Reynier (Sardon). Rizat 8 . Rona 1 . Schirajew 1 
Selenew 2 . Sturgis 5 . Szadek 1 ,-. 5 . 6 . 7 . 8 . Taylor 15 > 16 > 19 . Tchistiakow 3 * 8 * 9 
(Lewy). Thiry 5 . Thomaschewsky 2 . Trevisanello V Tur. Ussas 6 . Vig- 
uier 8 . Yakimovitch. Zeleneff 3 . 

Tongue. 

Blair 2 . Bulkley 36 . Buzenet 3 . Cooper, A. 3 . Fournier 35 . Grunfeld 2 . 
Hutchinson, J. 9 > 19 . Jullien 8 (Horteloup, P.). Kaposi 5 . Kenny. Kolo- 
mensky. MacCarthy. Mauriac 7 . Maurin (Vidal). Mra^ek 2 . Musset. 
Pajet, J. 1 . Pospelow 2 . Quinquaud 2 . Quinquaud and Nicolle 6 . Tchis- 
tiakow 15 . Thiry 4 . Tillaux (Rizat). Vidal, EJ1 3 . Viguter 6 . Weinberg 2 . 
Zeissl, H. 12 . 

Shoulder. 

Puche 3 . Suche. 



Bryant 4 . Bulkley 3 !. Fournier 35 , 70 . Gay, A. H. 3 . Goldenberg 1 . 
Pellizzari, P. 1 . Quinquaud and Nicolle 8 . Ricord 19 (Trousseau). Tar- 
dieu 13 . 



Fingers and hand. 



Allen 4 . Anonymous e. Bird 3 . Bloom 3 . Bulkley 3 b, 3k. Castel du 2 . 
Coyttarus 2 . Fournier l2 > 32 . Gay. Gay, A. H 3 . Hallopeau 2 . Henry 4 . 
Holsten. Horteloup, P. 3 . Hutchinson, J. 5 > 17 i 26 » 33 > 35 . Jelzina 2 . Lang 9 . 



SYNOPSIS OF FACTS AND LITERATURE 239 

Lewin 12 . MacCarthy. McGuire. Maunder 2 . Mauriac 9 . Mracek 5 > 6 . 
Neumann 30 . Ohmann-Dumesnil 4 . Pajet 2 . Pancritius -. Pellizzari, P. 5 . 
Pospelow J > 2 . Price, J. H. 5 (Sims). Ravogli j > 2 . Ricord 5 . Rizat 5 . 
Russell, C. P. Sigmund 13 . Sirski. Solovioff. Stevens. Symonds. 
Taylor 22 . Thomaschewsky 5 . Trevisanello 3 . Viguier 12 . Zwetitch 4 
(Mauriac). 

Trunk {in general). 

besnier 5 . bogoslovsky. bulkley 3m . fournter 50 . gay, a. h. 3 . 
Giovannini 9 . Mason 6 . Mauriac 13 . Moore 1 . Mraqek 9 . Ricord 16 . 
Tchistiakow 18 . 

Breast and nipple. 

Bloom 1 . Bulkley 3 c. Claude. Cooper, A. 2 . De Amicis 6 , also chin. 
Desmet 1 . Dimey. During 3 . Fournier 32 . Gay, A. H. 3 . Lewy and 
Goldberg 3 ' 9 . Marianelli 3 . Morel-Lavallee 7 . Pellizzari, C. 28 . 

Profeta 8 . Quinquaud and Nicolle 18 . Taylor 18 . 

Perineum ) anus, and picdetida. 

Fournier 50 . Gay, A. H. 3 . Hallopeau ] . Hutchinson, J. 30 . Mauriac 13 . 
Milbank. Moore 6 . Roussel 7 (Dron). Viguier 12 . 

Buttocks. 

Hutchinson, J. 3 . Marianelli 3 , Mracek 9 . 

Leg and thigh. 

Gay, A. H. 3 . Giovannini 7 . Klotz. Leloir 8 (Fournier, Lavergne and 
Perrin). Mason 7 . Mauriac 2 > 13 . Mracek 9 . Quinquaud 4 . Rona 7 . 
Viguier 12 . 

Foot. 
Hutchinson, J. 27 . Poisson 2 . 

Statistical Reports. 

Abelin. Anonymous n, q, r. Arcari K Arthur 1 . B^erensprung 1 . 
Barnes. BAssereau. Belousow 2 , 3 i 4 . Bergh '. Besnier 3 ^ Bidenkap *, 2 . 
Boeck, C. 1 . Boeck, W. 10 . Bogolubow 2 . Bohn. Bonnaric (Carriere). 
Breda 1 , 2 . Bureau. Calderini. Clerc >, 2 , 3 . Cripps ] . Desnos 2 . Diday 
4 , n . Diemer 1 . Dimey. Dron 5 , 7 . Eltzina 1 . Engelsted 6 . Evmenieff. 
Feulard '» 3 . Fournier ', 2 , 7 , 4C , «, 56 , 57 . Groedinger (Petersen). Herzen- 
stein *. Hulot (Fournier). Jarotsky l . Jelzina 1 . Klink. Kopp, C. 1 . 
Lang 2 . Lavergne and Perrin 1 . Luzinsky 4 . Mackenzie, M. Manassei. 
Martin 2 (Burlet). Martineau 1 (Binet 1 Des Molines). Migneco. Mik- 
hailoff >i 2 , 3 . Morel-Lavallee 5 (Fournier). Nikolsky 2 , D. P. Nikolsky, 
V. J. Nivet 1 * 8 . (Fournier). Nodet. Ostroumoffs, b, c, d, e, f. Pavlov 
J » 2 » 3 , 4 . Pellizzari, C. 1 . Peter 1 (Lassar). Petersen 2 . Popoff h 2 . 3 » 4 » 5 . 



* 



240 SYPHILIS INSONTIUM 

Pospelow 4 . Protzek. Puche ' (Fournier). Rassler 1 . Razumoff 1 . Ricord 1 . 
Robert, M. 1 . Rona 2 . Roster 1 . Roussel 1 . Sabinin. Salsotto >. Schu- 
bert 1 . Sigmund 5 , 17 , 18 . Speransky 5 > 6 . Sperck. Ssabinin. Stourme. 
Suchanek 4 . Tchistiakow '. Thomaschewsky 4 . Van Dugteren and Van 
Walsem ». Veslin >. WlRPSCHA. 

Infection per os. 

Bogolubow J. Bolschwing 4 . Broick 5 . Cordier j . Kobner 2 . Lewin », 
lip and throat 2 . Popoff 5 . Sabinin. Schubert 3 , fauces. Ussas 2 > 3 . Wolf 2 . 

Coitus preternaturalis . 

Buzenet 1 , lip, 3 tongue. Descroizilles, anus. During 4 , anus. Four- 
nier 46 . Griffin 4 , tonsil. Hartley, rectum. Massei, tonsil. Peter 1 , mouth. 
Plumert 3 , lip. Reynolds, tonsil. Solari, Eustachian tube. Waller 3 , anus. 



ANALYTICAL BIBLIOGRAPY 

OF 

SYPHILIS INSONT1UM* 



Abadie. 

Case, chancre, inner angle of eye, from kiss (see Viguier 9 -). 
Abelin, H. Stockholm. Children's Hospital and Poliklinik. 

Nord. med. Ark., Bd. xi , 1879, No. 1. (Viertelj. f. Derm. u. Syph., xiii., 

i88i,p. 158). 
Statistics, 1 868-1 878, incomplete — 17 cases of acquired syphilis. 

In Hospital, under 1 year, 2 cases acquired syphilis (11 2 congenital). 
In Hospital, over 1 year, 8 cases acquired syphilis, (1 congenital). 
At Poliklinik, with bone disease, 7 cases acquired syphilis (15 congenital). 
Abernethy, J. London. Surgeon to St. Bartholomew's; formerly assistant 
to John Hunter. 
11 Surgical and Physiological Works," 6th ed., London, 1825. 

1) Case, lactation syphilis of Watson, of Stourport. (Vol. I., p. 188). 

2) Case, finger inoculation in a medical student. (Vol. I., p. 194). 
Acton, W. London. Islington Dispensary; a former assistant to Ricord. 

"A complete practical treatise on venereal diseases, etc." London, 1841. 
(Abstracted also in Behrend's Syphilidologie, Vol., III., 1841). 

1) Case of Ricord's, chancre at site of venesection, p. 227. 

2) Case of Puche, infection from a prison-cot, p. 229. 

3) Case of Hildanus, infection from wearing another's pantaloons. 
Proceedings Westminster Med. Soc, Apr., 1844. (Cazenave's Annales des 

mal. de la peau, etc., t. ii,, 1845, p. 95). 

4) Case, syphilis in 8-year-old girl, probably contracted by innocent con- 
tact in bed. 

Lancet, London, Aug. 3, 1846, p. 127. 

5) Case, nurse infected by syphilitic nursling. 
Adams, J. London. 

Observations on Morbid Poisons, Chronic and Acute. 2d edit., London, 
1807, p. 181. 

1) Syphilis, Yaws, Sibbens, Elephantiasis, etc. 

Lancet, Nov. 12, 1861, II., p. 474; and Mason, q. v. obs. iv. 

2) Case, chancre of the lip, mistaken for epithelioma. 

* The larger share of the articles here quoted have been examined individually ; where the refer- 
ence is taken from another, credit is given ; in instances where there is question as to the correctness 
of the reference, an asterisk * has been inserted. 

17 



242 SYPHILIS INSONTIUM 

Adams, J. E. London. Ophthalmologist to London Hospital. 

"Trans. Ophthalmol. Soc. United Kingdom," 1883, Vol. III., p. 4. (Cited 
by Alexander, " Syph. und Auge," Wiesbaden, 1888, p. 22). 
Case, chancre of upper eyelid, source unknown. 
Adelasio, G. I. Bergamo, Northern Italy. Vice-conservator of Vaccine. 
"Relazione sopra casi di sifilide, letta al consiglio provinciale di 
sanita," Bergamo, 1864. ("Syphilis Vaccinale," by Acad, de Med., 
Paris, 1865). 

1) Epidemic, Torre del Buse, near Bergamo, 1862 ; five cases of 
vaccino-syphilis, and 19 others infected (p. 303). (See Epidemics). 

2) Three cases, two of vaccino-syphilis, at Alme, near Bergamo (p. 308). 
Admiralty Commission of the Army and Navy of Great Britain. Report on 

Venereal Diseases. London, 1867. 
(The material and evidence collected in reference to syphilis insontium, is 
presented in this Bibliography under the names of those testifying). 
Agasaroff, B. G. 

Proceedings of the Caucasian Med. Soc. for 1888. 

Numerous cases of extra-genital chancres from common use of handker- 
chief, shaving by syphilitic barber, etc. 
Agostini, A. Milan. 

" Stranguria quae venerea dicitur mercurii potest esse aliquid effectus." 
Venetiis, 1753. (Girtanner. " Abhandl. iiber die vener. Krank- 
heit." Gottingen, 1793, Vol. III. Bibliography, No. 1239). 
Case, infection in infancy from a wet-nurse. 
Albers, J. F. H. Bonn. Assistant at the Medical Clinic of the University ; 
formerly with Biett, Hop. St. Louis, Paris. 
"Ueberdie Erkenntniss und Kur der syphilitischen Hautkrankheiten." 
Bonn, 1832. 

1) Case, of Biett's, syphilis occurrirg from ritual circumcision (p. 17). 

2) Case, lactation, infant with acquired syphilis infects mother (p. 17). 

3) Four cases, nurses infected, without details (p. 17). 

"Ueber das Vorkommen der Lustseuche in Ostpreussen und Litthauen." 
Med. Zeit'g vom Verein f. Heilk. in Preussen, 1836, No. 22 und 23.* 

4) Description of Syphiloid of Lithuania. 
Alberti, M. Halle, Magdeburg. Professor of Medicine. 

"Systema Jurisprudentiae Medicae." Halae. 1723-1747; also with J. Heut- 
schel. " Dissertatio de occulo morbifico et morbifero," Halae, 1746. 
(Girtanner, Nos. 849 and 992, and Rust, " Helkologie, " Berlin, 1842, 
p. 246). 
Cases of infection by kissing : brief reference by Lancereaux. ' ' Treatise 
on Syphilis," Vol. II., p. 236. Also breast-drawing. (See Epidemics). 
Albinus, B. Frankfurt a. d. Oder. Professor of Medicine, ob. 1721. 

(Cited by Oelffen in Clossius, "Ueber die Lustseuche," 2d ed., Tubin- 
gen, 1799, pp. 41, 42, note). 
Case, infection of a child through wearing-apparel. 
Alexander. Aachen. Eye Institute, Director. 
"Syphilis und Auge," Wiesbaden, 18S8. 

1) Case, chancre, inner angle of eye, from a kiss (p. 6). 

2) Case, chancre of lower lid, in a physcian, from spraying a patient 
with syphilitic ozcena. 

AH6s. Luxeuil. 

"Memoire sur une epidemie de pseudo-syphilis." Gaz. med. de Paris, 
1844. (Rev. med. de Paris, Jan. 15, 1865). 
Epidemic near Luxeuil, 1840 and 1841, 80 infected (p. 154). 
(Probably through vaccination). (See Epidemics). 
Alison, R. H. Philadelphia. Infirmary for Nervous Diseases, services of Dr. 
Weir-Mitchell. 



ANALYTICAL BIBLIOGRAPHY 243 

"Syphilitic Choiea." Amer. Journ. Med. Sci., 1S77, ii., p. 75. 
Case, girl of 7 years, infected as infant from mother's nipple. 
Allen, C. W. New York. Surgeon to Charity Hospital. 
Journ. Cutan. and Vener. Dis., New York, 1885, p. 65. 

1) Two cases, chancre of the lip, origin unknown. 

2) Case, chancre of the cheek, in site of a razor cut. 
Journ. Cutan. and Vener. Dis., New York, 1888, p. 314. 

3) Case, chancre of upper lip, unmarried woman, 38 years old. 
Journ. Cutan. and Yener. Dis., New York, 1889, p. 147. 

4) Case, Chancre of ring finger, man, 35 years old. 
New York Med. Record, Jan. 2, 1392, pp. 7-8. 

5) Case, chancre of lower lip, in 19-year-old girl, origin not stated. 

6) Case, chancre of tonsil, in young married woman, origin not given. 
Trans. N. Y. Derm. Soc. 218th Meeting. Journ. of Cutan. and Genito- 

Urin. Dis., Vol. XL, 1893, p. 29. 

7) Case, chancre behind the ear at border of hair, probably inoculated 
by scratching with an infected finger. 

Allingham, W. H. London. Surgeon to St. Thomas' Hospital. 

" Communicability of Secondary Syphilis," Med. Times and Gaz., 1864, ii., 

P- 6 33- 
Two cases of supposed infection by semen ; proof very defective. 

Altounyan, A. A. 

Journal of Cutaneous and Venereal Diseases, Vol. III., 1S85, p. 61. 

An article on Aleppo button in which the author does not consider it 
identical with syphilis. 
Ambrosoli, C. Milan. Surgeon to the Ospedale Maggiore, Venereal Division. 
" Di una maniera non ancora descritte, etc.", and " Trammenti di clin. 
Sifil." Giorn. ital. di malattie veneree e d. pelle, 1867. 

1) Two cases, chancre of fauces, from cigar stumps (p. 259). 

2) Case, lactation, nurse infected by nursling, infects own infant (p. 35). 
Amoroso, G. Naples. Docent in Medicine, University. 

" Contribute alia trasmissione della sifilide.'' II Morgagni, Feb'y. 1881. 
Case of vaccino-syphilis (p. 99). 
Anderson, W. London. St. Thomas' Hospital. 

British Journal of Dermatology, Jan. 1889, p. 73. 

Case, chancre under right eye, from a friend, through wound-suction. 
Andrews, J. A. New York. Charity Hospital, Surgeon. 

Journal of Cutaneous and Venereal Diseases, New York, 1891, p. 217. 
Case, chancre of right lower eyelid, from attempt at removal of foreign 
body by the tongue. 
Andronico, C. Messina. 

Archiv di patologia, inf., Napoli, 1SS6, iv., p. 49.* 
Acquired infantile syphilis. 
Anger, B. Paris. Surgeon to Hop. Lariboisiere. 

Case, chancre of tonsil (see Morel-Layallee ' and Le Gendre"). 
Anger, Th. Paris. Surgeon to Hop. Cochin. 

Case, chancre of tonsil (see Le Gendre 3 and Brocq 3 ). 
Anonymous. 

1) Noveau Traite des Maladies Veneriennes. Amstelod, 1751, Vol. I., 
p. 183. 

a) Case, infection in mouth, in r2-ycar-old girl, from kissing. 

2) Fronep's Notizen, Weimar, June, 1829, No. 525. 

b) Case, nurse infected by nursling, infects a second nurse. 

c) Case, chancre of fauces ; a four months' old foundling, infectedby a 12- 
year-old girl by tasting the bottle (see Ruthenberg, Obs. x.and xi.). 

2a) Edinb. Med. and Surg. Journ., 1837, p. 133 (Beiirend's Syphilidologie, 
1840, Vol. 2, p. 449). 



244 SYPHILIS INSONTIUM 

Extract of an official report upon Radesyge and Syphilis by the physicians 
in the Swedish hospitals. 

3) Boston Med. and Surg. Jour., 1859, Vol. 59, p. 38. 

d) Case, chancre of middle finger, dentist from operation. 

4) Westminster Hospital. 
Lancet, London, i860, I., p. 573. 

e) Case, chancre of right middle finger, followed by buboes at the elbow 
and axilla, papular eruption; source unknown. 

5) Rendiconto Setti mestre dei mal. ven., etc. — Dispen. di Lorenzo in 
Napoli — Giorn. ital. d. mal. ven., etc. Milan, 1866, I., pt. 11., p. 91. 

/) Case, chancre on the right angle of the lip, in a child of 4 years. 

6) Revista Med. Quirurg. de Mexico, 1883, I. (Prensa Nacional, Review 
of Native Works, Seical), Nos. 11-14. 

g) Case, chancre of eyelid, in a physician, from pus of a bubo (said to 
be the only case of chancre of eyelid known in Mexico). 

h) Case, chancre of finger, in a midwife. 

i) Case, chancre of finger, in an attendant in hotel, from soiled 
garments. 

J) Case, chancre, velum palati, cause unknown. 

k) Two cases, chancre of lip. 

/) Several cases, chancre of the nipple in wet-nurses. 

7) A report of Zemsky medical men on " Syphilis in the Vladimir Gov- 
ernment" (Russia), 1884, P- 2 3- 

m) Among 333 cases of syphilis, 213 were infected per os; 57 through 
family life; 8 through suckling; 26 by heredity; and only 29 by 
coition. 

8) Trans, of the third General Meeting of the Sarator Zemsky (Russia) 
Medical Men, in 1887. 

n) Statement: the proportion of syphilitic patients (infected chiefly in 
a non-venereal way) amounts to from 8-10 per cent, of total number 
of patients observed. 

9) "Societe des Sciences Med. de Lyon." Journ. des Mal. Cutan. et 
Syphilis, Paris, Vol. II., 1890, p. 355. 

o) Case, chancre of lower lip, in a glass-blower; the same workman 
had previously infected three others. 
io)Ausziigeaus dem Tagebuch eines ausiibenden Aerztes, Theil I., p. 40. 
p) Case, infection of patient by finger moistened with saliva of oper- 
ator (an old woman) used to raise a fallen uvula. 

11) Report of District Medical Society. The Simbirsk Zemstro Herald, 
1890. 

q) Statements: In the district of Simbirsk, East Russia, syphilis is 
acquired through family life and other non-venereal ways in males, 
71.6 per cent, of cases, in females, 73.4 per cent. ; inherited in males, 
7.6 per cent, of cases, in females, 11. 1 per cent, of cases ; per coitum 
in males, 20.8 per cent, of cases, in females, 15.5 per cent, of cases. 

12) Propagation of syphilis by nurslings in Italy. British Med. Journ., 
Feb. 28, 1891, p. 499. 

r) The Italian Minister of the Interior sent a circular, dated Feb. 6, 
1 891, to all the prefects of the kingdom, calling their attention to 
the fact that ' 'cases of the diffusion in communes of the kingdom, of 
syphilitic infection, epidemic in character, depending on the suck- 
ling of nurslings suffering from that disease, are of not infrequent 
occurrence." 

13) Oester. Med. Jahrb., v., Heft ii., p. 21* (quoted by Sigmund; Lan- 
cereaux Traite, etc. , p. 42). 

s) An account of "Mal di Breno." 

14) " Ansteckung (syphilitischej durch Blutegel." Westphalischer Au- 
zeiger. Froriep's Notizen, Weimar, 1827, No. 3S1.* 

t) Syphilitic infection by means of a leech. 

15) " Mittheilung von der syphilis an und durch Hebammen." General- 



ANALYTICAL BIBLIOGRAPHY 245 

bericht d. k. rheinlandischen Med. Colleg., uber d. Jahr, 1828. 
Froriep's Notizen, Weimar 1832, No. 757.* 
u) Syphilitic infection of and by midwives. 
16) " Syphilisinfection beim Rasiren." Wiener Med. Blatter, 1886, ix., 

P- I339-* 
v) Syphilitic infection by shaving. 

Anstie, F. E. London. Westminster Hospital. 
Med. Times and Gazette, 1862, p. 534. 
Case, nurse infected by nursling. 
Appay, C. Paris. 

' ' Transmission de la syphilis entre nourrices et nourrissons syphilitiques, 
et notamment par 1' allaitement, avec considerationes medico-legales." 
Paris, 1S75, pp. 4S-66, and 9S-115. 

1) Case, forensic, arret de la cour de Lyon, 1852 (p. 93). Nurse in- 
fected by nursling, damages recovered from nurse-bureau. 

2) Case, forensic, arret de la cour de Dijon, 1868, (p. 94). Nurse infected, 
physician in charge not mulcted. 

3) Case of Fournier's (Michel), Lourcine, 1874, (Obs. I., p. 98), chancre 
of breast in a wet-nurse. 

4) Case of Fournier's, Lourcine, 1874, (Obs. II., p. 102), chancre of 
breast in a wet-nurse. 

5) Case of Gondonin, of Argentan, 1867, (Obs. V., p. 105), chancre of 
tonsil in a wet-nurse from bottle. 

6) Case of Le Dentu, Hop. St. Louis, 1869 (Obs. VII., p. 113). 
Nurse infected by nursling. 

(Other cases previously published). 

Arbo, N. 

Afhandl. om Radesygen eller Saltflod. Kjdbenh.,1792. Translated from 

Danish by Hensler, Altona, 1799. 
Arcari, A. Milan. Ospedale Maggiore (special division for venereal diseases) ; 

Institute di St. Corona (syphilitic out-patient service). "Lamedica- 

zione di Smirnoff nella cura della sinlide." Giorn. ital. d. mal. vener., 

etc., 18S6, p. 266. 

1) Statistics of 71 cases, during year October, 1885-1886. 

2) Four cases, chancre of breast in nurses. 

3) Two cases, cephalic chancre. 
Archambault. Paris. Hop. des Enfants-malades. 

1) Case, nurse infected at breast by nursling. 

2) Case, chancre of lip (infant of above) (see Pontet 4 ). 
Arlt, Ritter von. Vienna. University Prof, of Ophthalmology. 

Case, chancre of conjunctiva (cited by Wiethe 2 , q. v.). 
Arnal, Jean. Paris. 

Compte rendu de la Soc. Med. du 2^ Arrondissement, May nth, 1854 
(Union Medical, 1854, p. 508). 
Case, chancre of the upper lip (case of Piogey). 
Arning, E. Hamburg. 

" Mittheilungen aus der Universitatsklinik u. Poliklinik fur Hautkrank- 
heiten u. Syphilis,'' des Prof. Neissek. Viertelj. f. Derm. u. Syph., 
18S3, Vol. XV., p. 95. 

1) Case, infection of nursling by its mother. 

2) Personal communication ; chancre of nostril from towel, used in 
common with brother, with abundant mucous lesions. 

Arnould, J. 

Dermatologie Africaine. La Lepre Kabyle, Paris, 1862. 
Arthur, G. A. U. S. Naval Service, Surgeon. 

" On the Infrequency of Secondary Syphilitic Infection," New York Med- 
ical Record, Dec. iS, 1S86, p. 674. 



246 SYPHILIS INSONTIUM 



1) Statistics comprising the experience of 175 physicians in military, 
naval, and civil practice; of 37,000 cases of syphilis treated, but 41 
instances of secondary contagion were reported. 

2) Facts of Wilcox ; epidemic of tatooing, 26 infected. (See Epidemics). 

3) Case of Fitz, transmission by a drinking faucet. 

4) Case of Greenleaf, transmission by a cornet. 

5) Four cases, transmission by kissing. 

6) Two cases, transmission by pipes. 

7) Two cases, inoculation by bites. 

8) Case, chancre of finger in a physician. 

Astruc, J. 

De morbis veneris libri novem. Venetiis, Vol. I., 1760, (Annal. de Derm, 
et de Syph., 1888, p. 719). 

1) Mention of a sore on the palate, p. 285. 

De morbis veneris libri novem. Venetiis, Vol. I., 1760. (Allegem. Wien. 
Med. Zeit'g, 1877, p. 309). 

2) Mention of a sore on the eyelid, p. 291 . 

Atkinson, J. E. Baltimore. Prof, of Pathology, and Clinical Prof, of Der- 
matology, University of Maryland. 
"Extra-genital infecting chancre," Maryland Medical Journal, 1883-4, x., 
p. 2. 

1) Case, chancre of lower lip, in young woman, from kissing. 

2) Case, chancre of cheek, in 48-year-old man, no cause stated. 

3) Case, chancre of thumb, in a physician, midwifery. 

4) Case, chancre of inner surface of cheek, in 6-year-old child, acquired 
from her parents. 

5) Case, chancre of nostril, in an old woman who was in the habit of 
wiping the nose of a syphilitic grand-daughter with her own hand- 
kerchief. 

Aubert. Lyons. Hosp. de l'Antiquaille. 

Cases reported by Stourme, q. v. pp. 76-82. 

1) Twelve cases, chancre of the lips, two in glass-blowers. 

2) Case, chancre of the nose. 

3) Case, chancre of chin, after shaving. 

4) Case, chancre of eyelid. 

5) Case, chancre of the throat. 

6) Case, chancre of the soft palate. 
Cases reported by Roussel, q. v. 

About a dozen cases of acquired infantile syphilis during 1878-9. 

Audoynaud, J. H. Paris. 

" Etude de la syphilis communiquee par l'allaitement, avec considerationes 
medico-legales." These de Paris, 1869. 

1) Case, Fournier's, 1863, nurse infected (Obs. I., p. 14). 

2) Case, Fournier's, chancre, female breast, from a kiss. (Obs. II. p. 17). 

3) Case, Broca's, Hop. d. 1. Pitie, nurse infected. (Obs. III., p. 19). 

4) Case, Fournier's, infant infected by nurse, through bottle. (Obs. 
IV,, p. 21). 

5) Case, Bazin's, Hop. St. Louis, 1868, nurse infected. (Obs. V., p. 22). 

6) Case, Siredey's, Hop. Lariboisiere, nurse infected. (Obs. VI., p. 25). 

7) Case, Broca's, Hop. d. 1. Pitie, nurse infected. (Obs. VII., p. 26). 

8) Case, Triboulet's, Hop. St. Eugenie, nurse infected. (Obs. VIII., 
p. 28). 

9) Case, Simonet's, Hop. du Midi, nurse infected (p. 29). 

10) Case, Charpentier's, nurse infected (p. 29). 

Audry. 

Reported by Stourme, q. v., p. 57. 
Case, chancre lower lip, left side, in a gunsmith. 






ANALYTICAL BIBLIOGRAPHY 247 



Augagneur, V. Lyons. 

Reported by Stourme, q. v., p. 57. 

1) Case, chancre of chin, cause unknown. 

These de Lyon, 1879, P- 94 (Roussel " Pe la syph., tertiare," etc., 
1881, p. 127). 

2) Case, chancre of finger in medical man, from professional exposure. 

Auspitz, H. Vienna. Poliklinik, venereal service. 

Obituary notice of H. von Zeissl. Viertelj. f. Derm. u. Syph., XVI., 
1884, p. 547. 
Case, Prof. Zeissl, chancre of finger, auto-inoculation in opening a 
bubo. 
Auxias-Turenne. Paris. 

Proces-verbaux de la Societe Med. du Pantheon, Seance Feb. 13, 1856. 

1) Case, forensic, nurse infected by nursling (p. 19). 
Courier Medicale, Mai 30, 1863. 

2) Three cases of vaccino-syphilis in infants, in 1852. 

3) Case, vaccino-syphilis, from a pustule at the eleventh day. 

" Observations et Experiences de Syphilis Vaccinale," in " Syphilis 
Vaccinale," by the Acad, de Med., 1865, p. 385. 

4) Two cases of vaccino-syphilis in adults. 

Axenfeld. Paris. Hop. St. Louis, interne, service of Cazenave. 

Notes of a group of lactation syphilis (cases published by Cazenave, q. v.). 
Ayres, S. C. Cincinnati, U. S. A. 

Case, chancre of eyelid, from kissing (see De Beck). 
Badal. Bordeaux. Faculty Professor of Ophthalmology. 

Mem. et Bull. d. 1. Soc. Med. et Chirurg. de Bordeaux, 1886, p. 242. 

1) Case, chancre of lower eyelid. 

"Syphilis Oculaire," Journ. de Med. Bordeaux. 1 891, p. 379 (Viertelj. f. 
Derm. u. Syph., Vol. 24, 1892, p. 166). 

2) Four cases, chancre of the eylid. 

Baerensprung, F. von. Berlin. Charite Hospital, University Prof. 

" Mittheilungen aus der Abtheilung u. Klinik f. syphilitische Kranke." 
Third Report, i860, p. 71. 

1) Statistical, 15 cases chancre of lip, in six years. 

2) Case, chancre of upper lip from kissing. 

" Ueber hereclitare Syphilis." Berlin, 1864, pp. 151-179. 

3) Numerous cases of acquired syphilis in children. 
Bajanoff, D. N. 

Syphilis in the Tscheriugov government (South Russia) Russkaja Medic, 

1888. 
Statements: "Syphilis is a family disease," "infection mainly extra- 
sexual," "women and children infected more frequently than men," 
" the proportion steadily increases." 
Balducci, A. Florence. 

" Rapporto al Sindaco di Montecatini di Val di Nievole sui Casi di sifilide 
per allattamento in una sezione di quel commune, etc." Florence, 
1868, (Notice in Giorn. ital di mal. ven., etc., 1868, II., p. 382). 
Epidemic of lactation-syphilis caused by adoption of foundlings from the 
Florence Brefotrofio. (See Epidemics). 
Ballet. Paris. Hop. Lariboisiere. (Interne). 
Case, chancre of the lip (See Chauvet). 
Bang, L. 

Member of the Royal Commission appointed in 1778 to procure efficacious 
measures against Radesyge in Norway* (quoted by Bocck, " Traite 
d. 1. Radcsyge, etc.," i860, p. 10). 
Bangs, L. B. New York. 

Case, chancre of gum, from lead-pencil. (See Fox, G. H.). 



248 SYPHILIS INSONTIUM 



Baratoux, J. Paris. 

" Syphilis de l'oreille." Paris, 1886. 
Case, chancre of external ear, from a bite, (p. 56). 

Barbantini, N. Lucca. 

" Del contagio venereo, trattato istorico-teorico-pratico." Lucca, 1820-24. 

1) Said to contain first reported cases of vaccino-syphilis, those of Mar- 
colini and Cerioli. 

2) Case, infection of a little girl from her mother's chemise (cited by 
Profeta, "Trattato pratico," etc., 1888, p. 417). 

Barclay. Pittsburgh. 

Soc. Proceed. Allegheny County Med. Sou, Dec. 15, 1891. Journ. of the 
Amer. Med. Ass'n. Vol. XVIII. , 1892, p. 167. 
Case, chancre of lip, in young girl, probably from dental instrument. 

Bardinet. Limoges. Professor of midwifery. 

" De la Syphilis hereditaire et de satransmissibilitie," Paris, 1852. (Bull, 
de l'Acad. de Med., 1852, xviii., p. 274, and article in Journ. de Med. 
de chirurg., etpharm., 1S53, p. 611). 

1) Case, forensic, at Tulle, 1841, nursling infects two nurses. 

2) Case, nursling infects nurse. 

3) Case, same. 

4) Case, same. 

5) Small, lactation-epidemic. 

" Syphilis communiquees par le doigt d'une sage-femme," Bulletin de 
l'Acad. de Med., Paris, 1874, p. 15. 

6) Obstetrical epidemic at Brive, 1873. 

7) Obstetrical epidemic at Rochechonart, about 1855, facts by Bleynie. 
(See Epidemics). 

" Un Vaccinifere Syphilitique,'' Revue Medicale de Limoges, 1869, No. 5. 

8) Discussion on vaccinal syphilis by Depaul, q. v. 

Barduzzi, D. Pisa. University Clinic for Skin Diseases and Syphilis. 

"Se iniezioni ipodermiche mercuriali nella cura della sifilide," Giorn. ital. 
del mal. vener. e del. pel. 1884, p. 84. 

1) Case, chancre of chin, male, age 47 years (Obs. II. p. 89). 

2) Case, chancre upper lip, soldier, age 35 years (Obs. III., p. 89). 

" Sulla sifilide ereditaria." Giorn. ital. del. mal. vener. e del. pel., 1887, 

P- 134. 

3) Case, chancre of lip, in husband, causing 

4) Case, chancre of cheek in wife. 

Barillier. Bordeaux. Hop. des Enfants. 

Journ. de med. de Bordeaux, i860. (Tardieu; Etude medico-leg., 1879, 

p. 211). 
Group ; two nursing women and three nurslings infected by lactation. 

Barker, Edgar. 

. Med. Times and Gaz. London, 1857, p. 594. 
Case, chancre lower lip, from a towel. 

Barker, F. R. Portsea. Surgeon British Army. 
British Medical Journal, May 4, 1889, p. 985. 

12 cases of chancre of the forearm, in soldiers, from tatooing, all by 
same operator who had mucous patches in the mouth and used the 
saliva to wet the needles and mix the colors. (See Epidemics). 
Barling, G. Birmingham. Birmingham General Hospital, Assistant 
Surgeon. 
Birmingham Medical Review XXVII, 1S90, p. 169, and British Medical 
Journal I, 1890, p. 428. 
Case, chancre of lip, in man, 26 years old, supposed infection from 
tobacco-pipe. 



ANALYTICAL BIBLIOGRAPHY 249 

Barnes, R. London. St. Thomas Hospital, Accoucheur. 

Report of" -A rmy and Navy Commission on Pathology and Treatment of 

Venereal Diseases, 1867, pp. 475-480. 
Statistical, personal experience ; had seen syphilitic children of parents 
who seemed wholly free ; in a few cases, children seemed to have 
infected their wet-nurses. 
Barry, E. Dublin (Professor of Medicine) and London. 

"Account of a malignant lues venerea, etc.," Med. Essays of Edinburgh, 
1735 and 1752, 8°, III., pp. 297-304 (Colles' Pract. Observ. on the 
Vener. Dis. and Mercury, London, 1837, p. 19). 
Epidemic from breast-drawing and lactation, Cork, 1728 (See Epidemics). 
Barthelemy, F. Paris. Physician to Hop. St. Louis. 

Annales des malad. de l'oreille et du larynx, VI., January, 1880, p. 316. 

1) Case, chancre of fauces; source unknown (cited by Le Gendre, 
1884, q. v.). 

Archiv. d'ophthal. 1881. 

2) Case, chancre of eyelid (from service of Fournier). 
Cited by Zwetitch, Obs. V., q. v. 

3) Case, immense chancre of cheek, in a female. 
Bassereau, L. Hop. St. Louis et du Midi. (Interne). 

Traite des maladies de la peau, symptomatique de la syphilis. Paris, 1852. 

1) Statistics of own observations, total about 372, of which 20 were 
extra-genital; labial, 13; lingual, 4; gum, cheek and thumb, each 1. 

2) Family epidemic (p. 201). 

a) Case, chancre of lip and tongue, in a man. 

b) Case, chancre of lip, in his mistress, from her husband. 

c) Case, chancre of lip, in 7-year-old daughter of above. 

3) Case, chancre of lip, in a man, from kissing (p. 326). 

4) Case, chancre upon site of incision by foul instruments (see Jumon 2 ). 
Bataschoff, J. S. Talojina. 

" On Non-venereal Syphilitic Infection in Country practice." Meditzin- 
skoie Obozrenie, No. I., 1890, p. 18. (London Medical Record, May 
20, 1890, p. 187). 

1) Local epidemic of syphilis in Russian villages. 
Meditzinskoie Obozrenie, No. 12, 1892, p. 1121. 

2) Case, chancre, middle of upper lip in woman of 50, from grand-child 
to whom she fed chewed food with her finger. 

Baudon. Nice. 

Recueil d'ophthalmologie, Paris, Nov. 1885, p. 673. 
Case, chancre of conjunctiva bulbi, source unknown. 
Baudry, S. Lille. Professor of Surgical Pathology. 

"Contrib. a l'etude d. chan. d. paupieres." Archiv. d'ophthalmologie., V., 
No. I., 1885, p. 172. (Cited by G. De Beck, q. v.). 

1) Case, chancre of eyelid, 2-year-old child, from saliva on attendant's 
finger (p. 55). 

2) Case, chancre of eyelid, 4-year-old child, from saliva on mother's 
finger (p. 58). 

Baum, S. Prague. Prof. Pick's Division, Skin Diseases and Syphilis of the 
Poliklinik. 
" Zur Kenntniss der Extra-genital Sclerose." Viertelj. f. Perm. u. Syph- 
ilis, 1885, pp. 97-116. 

1) Case, chancre of lower lip, from kissing (Obs. I., p. 98). 

2) Case, chancre, lower lip, from a pipe. (Obs. V., p. 100). 

3) Four cases, chancre, lower lip, cause unknown. (Obs. II. . III., IV., 
VI). 

4) Case, chancre, upper lip, from kissing. (Obs. VIII., p. 102). 

5) Case, chancre, upper lip, cause unknown. (Obs. VII., p, 102). 

6) Case, chancre, eyelid, from a towel. (Obs. IX., p. 103). 



250 SYPHILIS INSONTIUM 

7) Case, chancre, cheek, from a bite (?). (Obs. X., p. 104). 

8) Case, chancre, chin, from tending an infant. (Obs. XI., p. 105). 

9) Case, chancre, chin, cause unknown. (Obs. XII., p. 105). 

10) Five cases, chancre of breast, from lactation. (Obs. XIII. -XVII. ). 

Baumes, P. Lyons. Surgeon-in-Chief to the Hosp. Antiquaille. 

" Precis theorique et pratique sur les malad. vener." Paris, 1840. 

1) Case, nurse infected by nursling, at nipple (p. 169). 

2) Case, nurse, infected as above, infects her own nursling (p. 171). 

3) Case, chancre of the nostril, cited by Ricord. 

Baumler, Chr. 

Handb. der chronischen Inf ectionskrankheiten ; Erster Theil — Syphilis. 

Leipzig, 1886. 
Speaks of the identity of syphilis and radesyge, syphiloid, Sibbens, 

skerljevo, etc. 

Baxter, E. B. London. Blackfriars Skin Hospital. 
Lancet, May 31, 1879, p. 769. 
Case, syphilitic inoculation, child, 3 years old, by tooth brush. 

Bayer, J. J. Altorf (?). 

Acta. Nat. Cur. III., obs. 26. 

Epidemic, obstetrical, known as "Mai de St. Euphemie." (See Epi- 
demics). 

Bayle. 

" Observations sur un ulcere chancreux a la levre inferieure." Journ. de 
med., chir. etpharm., Paris, 1767, XXVL, pp. 256-260. 
Case, chancre of lower lip. 

Bazin, X. Paris. Hop., St. Louis. 

1) Case, nurse infected by nursling. (See Audoynaud 5 ). 

2) Two cases, of glass-blowers syphilis. (See Viennois 2 ). 
Beauvais, A. G. Paris. 

Soc. de med. de Paris. Lyon medicale, 1866, p. 209. 

1) Case, chancre of finger, from a bite: amputation. 

2) Case of Gery, man inoculated his mother by biting her hand. 
Behrend, F. J. Berlin. 

Behrend's " Syphilidologie," Leipzig, 1839-1846. 

1) Family epidemic, industrial, weavers, from use of sprinkling tube. 
(Vol. III., 1 841, p. 512). 

2) Case, lactation, nursling infects nurse. (Vol. IV., 1843, p. 621). 

3) Case, nursling infects nurse, at breast, and she her own child. (Vol. I. , 
new series, 1858, p. 326). 

4) Case of infection through cigars held in the lips, but replaced in 
dealers stock. (Vol. IV., p. 325). 

5) Statement, undocumented, of infection by lancets. (Vol. V., 1844, 
p. 164). 

6) Statement, "has seen many cases of transmission by pipes." 
Belhomme, L. Paris. (See Martin, A.). 
Bell, B. Edinburgh. University Professor of Surgery. 

" Treatise on Gonorrhoea Virulenta and Lues Venerea," 1792, American 
edition. Albany, 1814. 

1) Statements, undocumented, of infection per partum; infection of 
midwives; auto-inoculation of surgeons; infection by kissing; by 
drinking-ware ; and by blood-letting with a lancet, used previously 
to open a bubo. (Part II., p. 9). 

2) Statements of eye-witness, but also undocumented, of infectiousness 
of Sibbens, its diffusion among families, between children, etc. 
(Part II., pp. 268-281). 

3) Case, chancre of scrotum, from soiled trousers. 






ANALYTICAL BIBLIOGRAPHY 251 

Bell, J. Hong Kong. 

Lancet, Aug. 4, 1888, p. 241. 

Case, chancre of tongue, from pipe or dishes. 
Belousow, P. Odojew, Russia. 

Medicinskoie Obosrenie, 1887, No. 21 (Abstract in St. Petersburger 
Med. Wochenschrift, No. 11, 1888, p. 97). 

1) Family infection; 3 cases, chancre of mamma; 1 of lower lip; 1 of 
upper lip; 2 of the tongue; 1 of soft palate; and 3 of the tonsils: 
total, 11. 

Zeitschr. f. Gericht Med. u. Allgem. Hyg. Bd., IV., 1885 (Russian). 
(Archiv f. Derm. u. Syph., 1889, p. 236). 

2) Statistics of 334 cases: family infection, 77 per cent.; lactation, 1.8 
per cent. ; hereditary, 10.12 per cent. 

Arbeiten des II., Congreses Russischer Aerzte in Moskow, 1887, p. 20. 
(Archiv f. Derm, u, Syph., 1889, p. 236). 

3) Statistics of 2765 patients: family infection, 66.3 per cent. ; lactation, 
2.2 per cent. ; hereditary, 5.4 percent; per coitum, 26 per cent. 

4) Statistics, in Rjasan; extra-genital infection, 74 per cent. 

Trans, of the 2d general meeting of Russian medical men at Moscow, 
1887, Vol. II., Div. 5, p. 20. 

5) Three cases, chancre of fauces, father and sons 8 and 6 years, source 
unknown. 

6) Case, chancre, left faucial arch, in a woman from her syphilitic child 
of 1 1 months ; the latter infected by a syphilitic relative. 

7) Case, chancre, mucous membrane of mouth, near angle of lips, in 
man of 22 years. 

8) Case, chancre, mucous membrane of mouth, near angle of lips, in 
boy of 8 years, whose father and sister were syphilitic. 

9) Case, chancre of uvula, in 18-year-old boy, from his nephew. 

10) Case, chancre, left faucial arch, in 22-year-old woman, from her 
i-year-old boy; the latter infected by a cook. 

11) Case, chancre, left tonsil, in married woman of 23, from neighbors. 

12) Case, chancre, near corner of mouth and on both lips in a boy of 
12 years ; living with syphilitic laborers. 

Bennett, J. E. Fort Smith. Arkansas. 
Southern Practitioner, 1883 p. 103. 

Epidemic of vaccino-syphilis at Fort Smith, 1863 — hundreds of soldiers 
and civilians inoculated from pustules upon one another. (See 
Epidemics). 
Bennett, J. H. Edinburgh. 

Journ. of Med. Sciences, Edinburgh. (Vol. XIV., 1852, p. 570). 

Two cases of syphilis acquired by two nurses from the same infant. 
Benson, A. Dublin. 

Transactions Academy of Medicine, of Ireland. (Vol. I., 18S3). 
Case, chancre of eyelid, from kissing (p. 367). 
Berbez. Paris. Hop. Cochin, interne, service of Despres. 

Case, chancre of little finger, from tooth inoculation. (See Guignard 7 ). 

Berger, F. H. 

" Do pseudo-syphilide," Inaug. Dissert., Gryphise, 1S32. 
Case, nurse infected from nursling. 
Bergeret. Paris. 

Moniteur des hopitaux, Nov. 29, 1853-. 

Group: three nurses and two nurslings, infected, scria/im, the first nurse 
from an heredito-Syphilitic nursling. 
Bergh, R. Copenhagen. Physician to General Hospital, Division for Skin 
diseases and Syphilis. 
" Ueber Anst. u. Ansteckungswcge bei Syphilis," Monatsh. f. prakt. 
Derm., 1888, p. 197. 



2 5 2 SYPHILIS INSONTIUM 

i) Statistics ; from 1872-1886, among 252 chancres m prostitutes, there 

were only 5 extra-genital; of these, lip 3, breast 1, calf 1 
2) Case, chancre gluteal region, from sleeping with comrade, with 
general pustular syphilide. 
Bernard, A. Liverpool. Lock Hospital. 

Liverpool Med. Chirurg. Journ., Jan., 1885. 

1) Four cases of syphilis in glass-blowers (pp. 183-6). 

2) Personal communication : case, chancre of finger in a phvsician 
obstetrical. r J 

Bernard, E. Amiens. 

Bullet, de la Soc. Med. d' Amiens, 1875, XIII. , XIV. pp. 104-8. 
Case, chancre of the eyelid. 
Bernard, P. Lyons. Chief of Clinic for Skin Diseases and Syphilis 
Journ. des mal. cutan. et syph. Pans. (Vol. II., p. 339). 

Case, chancre of left arm, in site of wound by a piece of stone, which 
was dressed by compresses which had been in use previously by others. 
Bertherand, A. Paris. Chief Physician, French Armies. 
" Precis des Maladies Veneriennes," 2d. ed., Paris, 1873. 

1) Case, chancre of tonsil, from kissing (p. 204). 

2) Small lactation epidemic, Paris, (p. 335). (See Cazenaves). 

3) Case of Guyon's, transmission by contact in bed (p. 20). 
Bertherand, E. L. Lille. 

Notice sur le chancre de Sahara. Gaz. des Hop., 1854, pp. - >Q , o OI 
A discussion concerning the nature of " Biskra button/' 
Berti, G. Bologna. Maternity Hospital. 

'' A°roh- de T i0n /r at J Ch ? d 'i gien v int ° rn ° -Hasifilide da allattamento. " 
Archiv. di patol. infant. Napoli, iP% „ / DD tok . 11q) 

Seven nurses infected by lactatv „ ' 3 (PP " 5 9) " 

Bertin, X. Paris. Hop. des ? r : • 

"Trait' rl 1 1 . v enenens, Surgeon. 

enceintes ™^ ' ' • jn ® r - cnez l es enfants nouveaux-nes, les femmes 

1) Case c>*'' e '^ s nourrices <" Paris, 1810. 

2) Cs r ' •' ijL11 ^" i n f ec ted by mother, through kisses, or dishes (p. 27). 
J r .^e, infant infected at vulva by bathing with saliva (p. 7S). 

j) Case, nursling infected mediately by the nipple, nurse, who was 
suckling an infected baby, escaping infection (p. 149). 

4) Case, nurse infected by nursling (p. 152). 

5) Case, infant infects mother's nipple (exception to Colles' law) (p. 163). 

6) Case, of Leblanc, nursling infects nurse (p. 187). 

Besancon, M. Paris. Hop. de la Pitie. (Interne). 

Case, Eustachian sound inoculation. (See Lancereaux). 

Besnier, E. Paris. Physician to Hop. St. Louis. 

Cited by Ory, q. v. "Syph. malig. precoces." These de Paris, 1875. 

1) Three cases, labial and faucial. 

Journ. de med. et de chirurg. pratique, 18S0. (Annales de Derm, et de 
Syph., 1880, p. 566). 

2) Three cases : 

a) Double chancre of lip and tongue, in workman, from fellow work- 
man, through brush used in common. 

b) Chancre, lip, in young girl. 

c) Case of Horteloup's, eleven chancres, labial and genital. 
Bulletin de l'Acad. de Med. de Paris, XIV., 1885, p. 12. 

3) Report of committee on the award of the Prix Vemois, Besnier, 
chairman, recommending work "Syphilis des Verriers," of Guinand's 
of Rive-de-Gier, Paris, 1881. 

a) Two cases, syphilis, in glass-blowers through medium of the tube. 

l>) Statistics, 41 glass-blowers treated for recent syphilis in theHosp.de 

l'Antiquaille, Lyons, from 1874-1882 ;from 1882-1885, nota single case. 



ANALYTICAL BIBLIOGRAPHY 25, 



Annales de Derm, et de Syph. Vol. X., 1SS9, p. 101. 

4) Case, chancre, middle of upper lip. 
Annales de Derm, et de Syph. 1889, No. 5, p. 463. 

5) Case, chancre in subclavicular region in a man, whose wife had 
mucous patches in mouth and on genitals. 

Journ. de med. et de chirurg. pratiques, LXL, 1890, p. 496. 

6) Case, chancre of tonsil in a man, infection probably from common 
use of a tobacco-pipe. 

Beurmann. 

"Chancres mammaires communiques a des nourrices par leurs nourris- 
sons." Annales de Derm, etde Syph.. Vol. I., 3d series, 1890, p. 424. 
Three cases, mammary chancres, all wet-nurses at 1' hospice des Enf ants- 
Assistes. 
Beyran, T. M. Paris. 

" Paralysis syph. d. motor-ocul. ext." Bulletin de 1' Acad, de Med., i860, 
t. XXV., p. 363. 
Case, chancre of chin, cause not stated. 
Bidenkap, T. L. Christian ia. Rigshospital. 
Klinisk Aarbog, for 1886. 

1) Statistics, etc. , on non-venereal syphilis. 

2) Statistics, negative, on vaccino-syphilis. 

Bierchen, P. Stockholm. President College of Physicians of Sweden. 
(Cited by Rosen von Rosenstein 3 , q. v., p. 752). 

1) Case, apparently a primary lesion of nostril, in 20-year-old youth. 

2) Case, chancre of lip, in a twelve year old girl. 

Bierkowski, L. J. Krakow. 

"Choroby syfilityczne czyli weneryczne oraz sporoby ich leczenia," 
Krakow, 1883. (Orignal account cited by Kosinski, 1867: the latter's 
account again in 1880, by Lubelski, and also by Matlakowski, q. v.). 
Circumcision epidemic, Krakow, over 100 infants infected. 

Biett, L. T. Paris. Hop. St. Louis, Senior Physician. 
(Cited by Albers, q. v.). 

1) Case, syphilis from ritual circumcision. 

2) Case, infant with acquired syphilis infects its mother. 

3) Four cases, nurses infected at the breast. 
(Cited by Cazenave, q. v.). 

4) Case, chancre of lip, in a man, from kissing, infects next case, 

5) Case, chancre of lip, his niece, 12 years old. 

6) Case, midwife infected in calling. 

7) Case, chancre of lip, in 6-year-old boy, from 8-year-old brother. 
(Cited by Ricord, from work of Martins). 

8) Case, chancre of nostril. 

Bigelow, H. J. Boston. Prof, of Surgery, Harvard University. 

Boston Med. Journ., Jan. 6, 1859. (Also in Durkee, "Treatise," etc., 
1864). 

1) Case, nurse infected at nipple, infects 

2) A woman, who drew her breast, and also 

3) Her 14 year-old-daughter (both in the throat). 

Bilguer. Berlin. Prussian Military Service, Surgeon-General. 

"Traite de l'hypoehondrie," pp. 71, 75. (Rosen von Rosenstein, 1769-98, 
p. 728). 
Epidemic, or cases from breast-drawing. (See Epidemics). 
(Episode said to resemble that described by Everardus). 

Binet, P. Paris. Hop. de Lotircine. (Interne). 

"Contribution a 1' etude du chancre infectant du vagin." La France 
Medical, 1SS1, I., pp. 38-50. 



254 SYPHILIS INSONTIUM 

i) Statistics, of Martineau, Hop. Lourcine: 128 cases; lips 8 ; vault of 
palate 1 ; tonsil 1 ; breast 1 (double chancre, one on nipple). 
" Du role de la syphilis dans le cecite." These de Paris, 1883. 
2) Case, chancre of cornea, in a medical student. 
Bird, F. D. Melbourne. 

Australian Medical Journal, July 15, 1S86, p. 304. 

1) Case, of Snowball, q. v., and Ryan, C. S. 1 , q. v. 
Australian Medical Journal, 1889, XI, No. g, p. 427. 

2) Case, chancre of nose, no particulars given. 

3) Case, chancre of finger, dorsal aspect of inter-phalangeal joint, 
source unknown. 

Bjorken, T. Upsala. Univ. Prof, of Surgery. 

" Syphilidolog. Antekningar" Upsala lakar, Forh., 1869. 

(Review by Bergh, in Virchow u. Hirsch Jahresbericht, 1869, II., p. 560). 

1) Case, chancre, back of hand, from a plaster previously worn on a 
syphilide. 

2) Numerous other non-venereal cases, not given by the reviewer. 

" Primar. Syphil. im undrelappen" Upsala lakar, Forh., 1878, XII., p. 452. 
(Virchow u. Hirsch Jahresbericht). 

3) Known only by above title. 

Blachez, E. Paris. Surgeon to Hop. Lourcine. 

"Deux cas de chancre du cou" by Fournier. Annales de Derm. 

et de Syph., 1S76, p. 66. (Notes by Blachez). 
Case, chancre of neck, from tooth inoculation. 
Blair, L. E. Albany. Swinburne Dispensary. 
Detroit Lancet, I883-4, N. S. VII. , p. 305. 

1) Two cases of chancre of lip, in men 24 and 26 years old. 

2) Case, chancre of tongue. 
Blanc, H. W. Tennessee. 

New York Med. Journ. Vol. LV., 1892, p. 287. 

1) Three cases, chancre of lip, two on lower and one double, on upper 
and lower. 

2) Case, chancre, right cheek, in female, probably from soiled towel. 

Blaschko, A. 

" Ein Fall von Lippensyphilis." Berlin, klin. Wochenschr., 1890, No. 27, 
p. 620. (Viertelj. f. Derm. u. Syph. Vol. II., 1890, p. 185). 
Case, chancre of upper lip, right side, patient 31 years old, from a bite. 
Blauchet, M. Paris. 

Quoted by Robbins, in Phila. Med. News. Vol. LX., 1892, p. 263. 
Author infected 27 individuals by Eustachian catheterization. 
Bleynie. Prof, d'accouchements a l'Ecole de Limoges. 

(See Bardinet). Bull, de l'Acad. de med. Paris, 1874, p. 319. 

Several infants infected by a midwife, rubbing umbilical cord with 
fingers moistened with saliva. (See Epidemics). 
Bloch, M. E. Berlin. 

"Geschichte einer Ansteckung durch Aussaug. d. Brust." Med. Bemerk., 
Berlin, 1774 (Girt anner). 
Case, chancre from breast-drawing. 
Blondeau, L. Paris. 

" Un cas de syphilis congeniale." Gaz. des Hop., 18S6, No. 71. 
Case, lactation, nursling infects nurse. 
Bloom, I. N. Louisville, Ky. Dermatologist Louisville City Hospital. 

"Extra-genital and other chancres." Medical Progress, 1891, VI., p. 2870 

1) Case, chancre, mamma in widow 46 years old, source unknown. 

2) Case, chancre, angle of jaw, in lady 22 years old, from a kiss. 

3) Case, chancre, left index finger, in man 22 years old, source unknown. 

4) Case, chancre, upper lip, in a prostitute, source unknown. 






ANALYTICAL BIBLIOGRAPHY 255 

*>) Case, chancre, left index finger, in a physician, source unknown. 
6) Case, chancre, right thumb, in a physician, source unknown. 

Blot. 

Case of vaccino-syphilis. (See Sebastian). 

Bloxam, J. A. London. Lock Hospital, Surgeon. 

Session Med. Soc, London, Jan. 24, 1887. British Med. Journ., 1887, I., 
p. 212. 
Case, chancre of both lips. 

Blumenbach. Gottingen. University Prof, of Medicine. 
Blumenbach's " Bibliothek fur Aerzten," 2> te - Bd., p. 197. 
Case, infection of a chamber-maid, by a tooth-brush. 

Boeck, C. Christiania. University Clinic for Skin Diseases and Syphilis. 
Tidskrift f. prakt. Med., 1883, No. 2. (Archives of Derm., 1883, XV., p. 
665). 

1) Statistics, lactation, from 1375-S ; four nurses, chancre of nipple. 
Tidskrift f. prakt. Med. 1S83, No. 13. (Archives of Derm., 1883, XV., p. 

647). 

2) Case, chancre of tonsil, virgo intacta. 

3) Case, chancre of tonsil, simple mention. 

4) Case, chancre of tonsil, from kissing. 

5) Case, chancre of tonsil, from common table-ware. 

6) Case, chancre of tonsil, from common table-ware. 

7) Case, chancre of tonsil, simple mention. 

Tidskrift f. prakt. Med., 1SS5, No. 15-16, (Monat. f. prakt. Derm., 1885, 
P- 456). 

8) Case, chancre of tonsil, from tending a syphilitic child. 

9) Case, chancre of tonsil, from a drinking-glass. 

10) Case, chancre of tonsil, source unknown. 
(Cited from Homolle). 

11) Case, chancre of finger, in young girl who washed her infected 
brother's linen. 

Boeck, W. Christiania. Rigshospital. 

Norsk. Mag. Vol. VI. (Gunezberg's Zeitschr. f. klin. Med., Bd. V., Hft. 
II., p. 137). 

1) Case, nurse infected by nursling. 

"Klinisk over Hudsygdome og Syphil. Sygdome, for 1852." Reprint 
from Norsk. Mag., Vol VII. 

2) Family epidemic; seven infected (pp. 74-76). 
"Syphilisationsforsog," 1853. 

3) Case, syphilis in child of 15, infected, by mother, at 6 (p. 28). 

4) Case, syphilis in woman of 24, infected when 8 years old (p. 36). 
" Syphilisation studieret ved Sygesengen," 1854. 

5) Two cases, Obs. IV. and XI., evidently non-venereal. 
"Syphilisation as a mode of treatment, etc." Behrend's Syphilidologie, 

1858. 

6) Case, nurse-mother, infected by nursling, transmits to own child a 
chancre of lip (Obs. XLV., p. 567-572). 

7) Case, nursling infected by strange nurse, with chancre of the lip, 
transmits labial chancre to mother (Obs. LVI., p. 577). 

Traite de la Radesyge (syphilis tertiaire), Christiania, i860. 

Contains much of the literature of this subject. 
" Ueber Syphilis der Kinder." Behrend's Syphilidologie for 1862. 

8) Case, nursling, infected by a nurse (p. 515). 

9) Case, nursling, infected by a nurse, chancre of lip (p. 516). 

" Recherches sur la Syphilis, etc." Christiania, 1862 (in French and 
Norwegian). 
10) Statistics ; several thousand cases of chancre. (Many cases of syphilis 



256 SYPHILIS INSONTIUM 

insontium are detailed, but it is difficult to distinguish them from 
those already reported). 
" Ueber syphilitische Infectionweisen,'' etc. Archiv f. Derm. u. Syph., 
1869, p. 168 (cites cases from his work, 4 ' Recherches," and adds) 

11) Case, chancre of tongue, in nursing infant, from mother's breast 

(p. 171). 

12) Case, chancre, lower lip, male, 36 years old (p. 175). 
" Erf ahrungen iiber Syphilis." Stuttgart, 1875. 

13) Case, chancre of tongue, in an infant, mother syphilitic (p. 108). 

14) Case, chancre, tip of tongue, from a pipe (p. 109). 

15) Case, child infected by nurse, who chewed its food (p. 137). 
(Quoted by Hock, q. v. 2 ). 

16) Case, chancre lower eyelid. 

Boerhaave, H. Leyden. Professor of Medicine. 

" Praelectiones Academicse de lue Venerea." Franquerae, 1751 (p. 6). 

1) Small epidemic among women, who kissed an infected infant (§ XL). 

2) Case, a mother and her nursling infected, through the latter having 
had the breast of a strange woman (§ XIV.). 

3) Case, lactation, nursling infects a nurse (§ XV.). 

Boettger. Dresden. 

Memorabilien, II., 1878, xxiii., p. 63. 

Case, child 9 years old, with tertiary acquired syphilis, infected by 
syphilitic nurse, who chewed its food. 

Bogolubow, N. F. Cronstadt. Marine Hospital, Surgeon. 

Med. Pribav. k. Morsk. Sbornikii Med., May, 1884, pp. 51-58. (Archiv 
f. Derm. u. Syph., 1889, p. 237). 

1) Five cases of syphilitic infection per os. 

Med. Pribav. k. Morsk. Sbornikii Med., 1885, Nos. 3, 4. (Same reference). 

2) Statistics, 753 cases of syphilis: lips 2; eyelid 1 ; tonsil 1. 

Bogoslovsky, G. I. 

Meditzinskia Pribav. k. Morsk. Sbornikii Med. (British Journ. of Derm., 
Sept., 1889, p. 383). 
Case, chancre of abdomen, near navel, inoculated through an abrasion. 

Bohn, A. Konigsberg. Private Docent to the University of Konigsberg. 
Schmidt's Jahrbiicker, 1863, CXX, pp. 97-109. 

General review of vaccinal syphilis; Cases of Ceccaldi, Cerioli, Glat- 
ter, Haydon, Hubner, Lee, Marcolini, Pacchiotti, Pitton, Rine- 
cker, Viani, Viennois, Waller, Wegeler, Whitehead, etc. ; of a total 
of 312 persons vaccinated, 219 were infected with syphilis. 
Bolschwing, T. von. Dorpat. Hospital at Riga. 
" Ueber Syphilis und Aussatz." Dorpat, 1839. 

1) Case, chancre of lip, common use of cup and spoon. (Obs. 4, p. 55, 56). 

2) Case, infection per os, common use of spoon. (Obs. 5, p. 56, 57). 

3) Case, infection per os, fauces (?), from a nursing-bottle. (Obs. 6, p. 57). 

4) Case, infection peros, exposure to syphilitic relative. (Obs. 7, p. 58). 

5) Case, infection in infancy, through common use of cradle. (Obs. 8, 

P- 59)- 

6) Case, infant infected, father syphilitic. (Obs. 9, p. 60). 

7) Case, infection per os, from a pipe. (Obs. 10, p. 62). 

8) Seven other observations, comprising numerous cases of family 
syphilis, which could equally be of venereal and hereditary nature 
(p. 62-74). 

9) A treatise on the relation of the Syphiloid of Lithuania, Jutland, etc., 
to Syphilis and Leprosy. 

Bondet. Lyons. Prof, of Internal Pathology. 
Rollet. "Traite etc.," 1866, p. 617. 
Case, chancre of scrotum, from infected trousers. 



ANALYTICAL BIBLIOGRAPHY 257 

Bonnaric. Lyons. Hosp. de l'Antiquaille, female service. 
Rollet. "Traite, etc.," 1S65, p. 705. 

Chancre; Statistics collected by Carrier, interne, for Rollet' s treatise. 
See Carrier and Rollet. 
Bonnet, J. Lyons. 

Cited by Rollet. "Traite des mal. vener.," 1S65, p. 693. 
Case, chancre of nose. 

Bonne vie, H. 

Appointed in 175S to study Radesyge in Egersund and Stavanger (quoted 
by Lancereaux "Treatise on Syphilis (New Syden. Soc. 1S6S)" Vol. I., 
P- 35)- 
Bonniere. London. 

London Lancet, June iS, 1S70. 

Case, vaccino-syphilis, from soiled needle. 
Bonorden, H. F. Berlin. 

" Syphilis/' Berlin, 1S34. 
Case, chancre at site of incision for venesection (p. 41). 
Bontius, J. 

Medicina Indorum., Lugd. Batav., 1718 (quoted by Rayer "Traite theor. 
et prat. d. mal. d. 1. peau.," 2d edit., Paris, 1835, Vol. III., p. 864; 
and by Rollet, " Traite, etc.," 1866 (p. 481).* 
An original account of Amboyna pimple. 
Booth. Sheffield, England. 

" Epidemic of Syphilis caused by a midwife." Fortschritte der Medicine, 
March 1, 1S83, Beilage 5 (p. 34). 
A midwife had a chancre of the finger, and, in spite of a command to 
the contrary, continued to practice, covering the finger with a glove. 
She infected a great number of lying-in women, who in turn gave the 
disease to their husbands and children. The midwife was condemned 
to 1 2 months, at hard labor. 
Borgarutius, P. Paris. Physician to Henry II. of France. 
" Methodus de morbo Gallico." Patavii, 1566. 
Case, chancre of finger, in a midwife. 
Borovsky, V. K. Kiew. 

Vratsch., 1892, No. 11. p. 274. 

1) Case, chancre of left tonsil, in a man, source unknown. 

2) Case, chancre of both tonsils, in a man, source unknown. 
Botallus, L. Piedmont. 

"Von der Fran tzosen-Krankheit und ihrer Cur." Nurnberg, 1676; from 
the latin ed. of 1563. 
Case, chancre of lip, from a drinking-glass (p. 41). 
(Mentions also infection by clothing, kissing, etc.). 
Bottex, P. Lyons. Hosp. de l'Antiquaille. 

Behrend's Syphilidologie, Vol. I., 1S39, p. 536. 

Case, nursling infects nurse, and she her own child. 
Bottey, F. Paris. Interne du Hop. Midi. 

Annales de Derm, et de Syph., 1SS3, II., Ser. IV., p. 435. 
Case, chancre back of hand, from washing linen of patients. 

Bouchacourt, A. Lyons. Faculty Professor. 

" Consultation medico-legale sur vine cas de syphilis communiquee de 
l'enfant a sa nourriee par rallaitcment." Revue med francaise et 
etrangere (Cayol), 1841, t. II., pp. 228-235. 
Family epidemic from lactation. 

Boucher, de la Valle-Jossy. Paris. Hop. du Midi. (Interne). 

(Contributor to Fournier's statistics, in the " Etude sur le chancre 
cephalique," 1858, q. v.). 

18 



258 SYPHILIS INSONTIUM 

Boucheron. Paris. 

L'union medicale, 1879, No. 6, Vol. XXVII. 

1) Case, chancre, eyelid (plica semil.) from kissing (p. 529). 

2) Case, chancre, eyelid, in prominent surgeon, from auto-inoculation 
with the fingers (p. 533). 

Bouchut, E. Paris. Hop. des Enfants-Malades. 

11 Memoire sur la transmission de la syphilis des nouveaux-nes aux 
nournces." Mem. de la Soc. de biol, 1849. (Gaz. med. de Paris,. 
1850, p. 296). 

1) Two cases, nurses infected by nurslings (Rayer, q.v.). 

" Traite pratique des maladies des nouveaux-nes," 5th ed., Paris, 1867. 

2) Case, lactation, nursling infects nurse, she her own child (p. 1057). 

3) Case, epidemic of lactation-syphilis (p. 1058). 
Boudinet. 

Bulletin de 1' Acad, de med., Paris, 1878. (Cited in Archiv f. Derm. u. 
Syph., 1889, p. 237). 
Case, midwife with chancre of finger, infected lying-in women. 

Boue. 

Essai sur la maladie de Scherlievo, Paris, 18 14.* 

Bouilly, G. Paris. Hop. Beanjon, Prof. Agrege. 

Arthropathies, rheum., scrof. , et syph. These d' aggregation, Paris, 1878. 

1) Sequel of case of vaccino-syphilis, reported by Ollier, q. v. 

2) Case, rag-picker infected on right little finger. (See Fournier's 
" Lecons tabes d'orig. syph.," p. 414). 

Boulangier. 

La Clinique, Bruxelles, Jan. 26, 1888, p. 51. (Monats. f. prakt. Derm.,. 
18S8, No. 8, p. 387). 
Case, chancre of the nose. 

Bourcy, P. 

Cited by Mauriac. " Syphilose du rein," Paris, 1887, p. 21, without 
references. 
Case, chancre of upper lip in a man of 23 (Obs. 21). 

Bourdais, Eugene. 

Contrib. a l'hist. des accid. grav. consec. aux vaccinations faites par une 
sage-femme. These de Paris, 1869, p. 36.* (Cited by Roussel. 
"Syph. tertiaire," Paris, 1881, p. 205). 
Bourdon. Paris. Hop. d. 1. Charite, Physician. 
Cited by Ory. q. v., pp. 26-7. 

Case, Charite, 1875; vaccino-syphilis in female, age 53 years, scarifier 
was not cleaned, blood carried from one to the other. 
Bourgeois, Madame Louise (Burgesius). Paris. Midwife to Marie de Medicis. 
"Traite des accouchements," 160S, II. , 42. (Rosen v. Rosenstein "Kinder- 
krankheiten." Gottingen, 179S, p. 72S). 
Epidemic of obstetrical syphilis, thirty-five families infected. (See 
Epidemics). 

Bourgogne, F. (pere). Lille and Brussels. 

" Contag. des mal. verier, des enfants trouvees et leur nour." Lille, 1825, 
and " Consid. gen. touchant les dif. modes de contag. et de transm. 
accid. de la mal. vener (syphilis)." Journ. de med. de Bruxelles, 
1866, pp. 97, 217, 322. 
1) Epidemic at Conde. 1822-4. (See Epidemics). 

a) Nurse, from hospital foundling, infected 

b) Breast-drawer, she infected 

c) Fourteen nursing women, these infected 

d) Their fourteen nursing infants, these infected 
i) Five nurses, these infected 

f) Five of their own children. 



ANALYTICAL BIBLIOGRAPHY 259 

2) In addition to the above. 

a) Nurse, from adopted foundling, who then infected 

b) A second adopted foundling. 

c) Two nurses, infected by adopted foundling. 

3) Case, young lady, infected by a comb, used by syphilitic friend. 
(Note: These cases are referred to by Guntz. ("Verhiitung d. Syph." 

pp. 26-62, as of recent date, but correspond to the epidemic at Conde). 
Bousquet. 

Canstatt Jahresbericht, 1865 (Zeissl; " Lehrb. der Syph.," 3d. edit. 1875, 
pt. II, p. 37). 
Three cases of Eustachian sound infection. 
Bouvier. Paris. 

"Syphilis vaccinale." Acad, denied., Paris, 1S65, pp. 162-172. 

1) Epidemic, Marone's, of vaccino-syphilis, at Lupara, 1856. (See 
Epidemics). 

2) Case of Morax's, vaccino-syphilis. 
Bovero, Rinaldo. 

Giorn, ital. d. mal. ven. e della pelle XXVII., Mar. 1892, p. 37. 
Case, chancre from cut by razor, in man of 41 years. 
Boyer, P. Paris. Hop. St. Louis, Surgeon. 

Gaz. med. de Paris, 2d series, VIII., Nov., 1840, pp. 753-769. (Behrend's 
Syphilidologie III., 1841, pp. 299-322). 

1) Case, chancre of nipple, in a paraplegic woman, infected 23 years 
before by a nursling (p. 322). 

2) Case, chancre of nipple, in a male, by a bite (p. 317). 
Boys-de-Loury, J., and Barthelemy. 

Annal. d' hyg. pub. et de med. leg., Paris, 2d ser., 1869, XXXI., pp. 423- 
430. 
Case, nurse infected by nursling. 
Boys-de-Loury and Costhilhes. 

Gaz. med. de Paris, 1847, 3d ser., II., p. 275. 

Case, chancre lower lip in a girl, source unknown . 
Brambilla, G. A. 

Gaz. med. ital., Lombarda. Milano, 1877, 7th ser., IV., No. 24. 
Case, chancre of finger, professional infection of a midwife. 
Brandis. 

De morbo in Holsatiae nonnulla regione grassante contagioso ex genere 
leprae observationes. Hall. Allg. Litt. Zeitung, 1811. Bibliothek for 
Laeger, 1813, I. (Quoted by Boeck " Traite d. 1. Radesyge," etc., 
i860, p. 46).* 
Treats of the morbus Dithmarensis. 

Brandis, B. Aachen. Geh. Sanitatsrath. 

"Grundsatze bei der Behandl. d. Syph.," 3d ser., 1886. 
Case, chancre of finger, in a medical man (p. 37). 

Braquehaye, J. Bordeaux. Prof. Dubreuilii's clinic for Skin and Venereal 
diseases. 
Annales de la polyclinique, 18S9, p. 124. 

Case, multiple chancre of face ; one each on cheek, lip, and chin. 

Brassavola, A. M. Ferrara. 

Tractatus de morbo Gallico, 1551. (See Aphrodisiacus). 
Case, nursling, infected by a nurse, infects its mother. 

Brecher, G. 

"Die Beschneidung der IsraDliten," etc., Wien, 1S45, S -; 1-2 Bogen. 
(Cited in Jaffe, "Die rituelle circumcision," 1886, p. 31). 
Case, circumcision-syphilis, one of many infected together. (See 
Epidemics). 



260 SYPHILIS INSONTIUM 



Breda, A. Padua. University Clinic for Skin diseases and Syphilis. 

" Rendiconto clinico." (May, 1878 to Dec. 1880). Giorn. ital. d. 

mal. vener., etc., 1881, p. 27. 

1) Statistics ; lip 3, tongue 1, buccal cavity 2, tonsil 1, cheek 1, nipple 

5. =13. Of these, six were in nurses, five with chancre of nipple, and 
one chancre of tonsil, all from nurslings. 
" Manuel de Malattie Vener. e sifil." Padua, 1887, p. 239. 

2) Statistics, from Dec. 1880 to May 1886; lip 11, cheek 2, neck 3, nipple 
11=27. Grand total from May 1878 to May 1886=40. 

Breinlinger, Konrad. 

Impf syphilis. Inaug, Dissert. Wiirzburg, 1882, p. 22.* 
Breyer, J. F. Brussels. 

Cited by Cunier, q. v., in his " Annales d'ocul." 

Case, chancre of eyelid, girl 31-2 years old from fondling and kissing. 
Brincken, von. Angeln. 

" Ulcus durum auf der Innenflache der oberen Augenlider." Zehender's 
klin. Monatsbl. f. Augenheilk., Stuttgart, 1884, XXII., p. 371. 
Case, chancre, inner surface of upper eyelid. 
Brinton, W. Baltimore. 

Case, chancre of nose, bite-inoculation, reported by Rohe, q. v. 
Bristowe, J. H. London. St. Thomas Hosp., Senior Surgeon. 
" Report med. off. Gov't. Board, 1883, XII., p. 46. 

Official report of Commisssion on Dr. Cory's Auto-inoculation. See 
Cory and Hutchinson. 
Broca, P. Paris. Hop. de la Pitie, Physician. 

1) Two cases, chancre of lip, in Fournier's " Chancre cephalique," 1858. 

2) Two cases, lactation syphilis for Audoynaud, q. v. 3 , 7 . 

Brocq, L. Paris. 

Annales de Derm, et de Syph., 1883, p. 362. 

1) Two cases, chancre of conjunctiva. (Service of Fournier). 
Annales de Derm, et de Syph., 1887, p. 209. 

2) Case, chancre of lachrymal caruncle, left eye ; boy 2 years old. 
(Service of Besnier). 

3) Two cases, chancre of the tonsil. (Service ' of Th. Anger and 
Laboulbene). See Le Gendre. 

Broick, J. Bonn. Prof. Doutrelepont's University Clinic. 

"Ueber extra-genital Initialsclerosen." Inaugural Dissertation, Bonn. 
1888. 

1) Eight cases, chancre of lip, six females and two males. 

2) Six cases, chancre of finger, 3 in surgeons and 3 in midwives. 

3) Three cases, chancre of nipple, nurses from nurslings. 

4) Case, chancre, left arch of palate, in female, from infected foster 
child. 

5) Case, infection per os, in a male. 

Reported by Dr. Krelling, q. v. in Dr. Lesser' s clinic. 

6) Case, chancre, inner canthus of eye, in a male, source unknown. 

7) Case, chancre of nose, from infected saliva, in an eysipelas abrasion. 
1 * Ueber extra-genital Syphilisinfection." Archiv f. Derm. u. Syph. Vol. 

22, 1S90, p. 497. 
Statistics : 215 cases of syphilis 1 1 of which were extra-genital. 

8) Seven cases, chancre of lip, five females and two males. 

9) Case, chancre of finger, in a midwife. 

10) Case, chancre of tonsil, in a female. 

11) Case, chancre of chin, from a razor cut. 

12) Case, chancre, inner surface right thigh, from sleeping with 
syphilitic. 

Bronson, E. B. New York. 

Journal of Cutaneous and Venereal Diseases, 18S9, p. 67. 



ANALYTICAL BIBLIOGRAPHY 261 



1) Case, chancre of tonsil, 8-year-old girl, from mother. 

Trans. N. Y. Dermatol. Soc, 218th meeting. Journ. of Cutan. and 
Genito-Urin. Dis. Vol. XL, 1893, p. 28. 

2) Case, probable chancre, front of thigh, in hospital nurse, who 
attended syphilitic patients, and inoculated herself presumably by her 
soiled finger, through a scratch. 

Brouardel, P. Paris. Physician to Charite. 
Clinique medicale de la Charite, 1874. 

1) Two cases, Eustachian infection, in children, one fatal. 

2) Case of Eustachian infection, reported by Bucquoy, q. v. 

3) Cases of chancre from bites, reported by Lesage, q. v. 

Brousse. Montpellier, France. 

L' union medicale, 1S90, Vol. L., p. 450. 

Case, seven hard chancres on the face, man 32 years old, presumably 
from razor cuts. 

Brown, F. T. 

Journal of Cutaneous and Genito-Urin ary Diseases, Vol. X., June, 1892, 
P- 235. 
Case, chancre of ring finger, right hand, in young man, from a bite. 

Browne, Lennox. 

Brit. Laryngolog. Ass'n. Revue de Laryngol. (Journ. des mal. cutan. et 
syph., Vol. IV., 1S92, p. 211). 
Case, chancre of cheek, in girl of 18, from bite by a man with a sore 
throat. 

Bruneau, E. Paris. 

" Transmission d. 1. syphilis d'un nourrisson." Gaz. des Hop., 1864. 
Case, nursling infected by wet-nurse (p. 150). 

Brunelli. Rome. (See Cerasi). 

Brush, E. N. Philadelphia, U. S. A. 

"Session Phila. Neurolog. Soc, April 26, 1887." Phila. Med. News, 
July 9, 1887 (Vol. LI., No. 2). 
Case, chancre of thumb, in a medical man, later developed nervous 
syphilis (p. 49). 

Bryant, T. London. Guy's Hospital. 

" Chancres in adults and children, in unusual situations." Lancet, 1868, 

P- 525. 

1) Two cases, chancre, upper lip, source unknown. 

2) Two cases, chancre, lower lip, source unknown. 

3) Case, chancre, angle of mouth, source unknown. 

4) Case, chancre, forearm, source unknown. 

5) Case, chancre, nipple, in a female from kissing. 

6) Case, triple chancre of finger, direct contact. 

7) Case, chancre of cheek, from finger-nail wound. 

8) Case, chancre of lip, boy of 7, from his father by kissing. 

9) Two cases, children, boy slept with infected relative. 

10) Case, infection, child of 4 years, source unknown. 

11) Two cases, chancre of lip, aged 7 years and 10 months, father 
syphilitic. 

Bryce, C. A. Richmond, Va. Editor of the Southern Clinic. 

"Syphilis from accidental causes. " .Southern Clinic, 18S3, VI., p. 266. 
Case, chancre, lower lip, in young man, from drinking repeatedly from 
a whiskey flask, after a man with constitutional syphilis. 

Bucci, A. Bologna. Osped. di St. Orsola. 
Giorn. ital. d. mal. ven. etc., 1885, p. 267. 
Case, chancre of finger, from a bite. 



262 



SYPHILIS INSONTIUM 



Buch, M. Finland. 

Findska Lakares. Handb., 1888, No. 6, p. 303. (St. Petersburg, med. 
Woch. 1888, No. 30, p. 261). 
Three cases, chancre of upper eyelid, from application of tongue or 
finger moistened with saliva to the eye, by a female quack. 
Buchanan, G. Glascow. Professor of Surgery. 

"Case of Sibbens." London Med. Gaz., 1836, XIX, p. 44 
Infection in throat after using same pipe and spoon with infected person 
(corresponds exactly with description of cases of Eustachian infection 
and throat chancre) . 
Buchholz, W. H. S. Hofmedicus at Weimar. 

Annotations to Loder's translation of Rosen v. Rosenstein's work on 
diseases of infancy, 6th ed., Gottingen, 1798. 
Case, infection per os, from a drinking glass (p. 728). 
Bucholz, I. 

Tidskrift for prak. Med., Kristiania, 1888, p. 305. (Archiv f. Derm. u. 
Syph., 1891, p. 328). 
Case, chancre of tonsil in old woman who had cared for a syphilitic 
child. 
Bucquoy. Paris. Hotel-Dieu. 

L' union med., 1865, XXVII., p. 189. 

1) Case, Eustachian infection, in a youth of 21. 

(This case also under observation of Brouardel and Cullerier). 

2) Case, of Danyon's and Cullerier' s, Eustachian infection; patient 
infected her husband. 

Budor, G. Paris. Hop. Beanjon. (Interne). Service of Millard. 

"Paraplegie syphilitique." Annal. de Derm, et de Syph., 1887, p. 188. 
Case, chancre of lower lip, followed by tabes dorsalis (see Millard). 
Budugoff, A. I. St. Petersburg. 

Vratsch No. 1, 1892 (St. Louis Med. and Surg. Journ., June, 1892). 

1) Case, chancre, lower lip, in man of 23 years, from cigarette smoking. 
Vratsch No. 10, 1892 (St. Louis Med. and Surg. Journ., June, 1892). 

2) Case, chancre, right tonsil, in young recruit, who, in leaving the 
village, had, as is the custom, kissed every one of the inhabitants. 

Bulkley, L. D. New York. Skin and Syphilis Clinic, New York Hospital. 

1) " Two cases of chancre of the lip, infection from cigars." Archiv. of 
Derm., 1879, PP- 343, 372- 

2) "Non-venereal Syphilis." Trans. New York State Med. Soc. 1886, 

P- 393- 

"Syphilis as a non-venereal disease." Journ, Amer. Med. Asso'n, 

Dec, 1888, p. 865. All cases included in 

3) " Unusual methods of acquiring Syphilis." Phila. Med. News, Mar. 
2 and 9, 1! 



a) Chancre of the lip, 

b) 

c) 

d) « 

e) 

/) " 

g) 

h) 

i) 

J) 
k) 
I) 
m) 



male 13 female iS total 31 



finger, ' ' 
breast, " 


6 


tonsil, 


2 


tongue, " 
cheek, 


3 
3 


chin, " 


1 


eyelid, " 


2 


nose, " 


1 


ear, " 


1 


hand, " 


— 


forearm, " 


1 


sacral region, " 


1 


Total, 


34 



32 



66 



ANALYTICAL BIBLIOGRAPHY 263 

4) " On the dangers arising from syphilis in the practice of dentistry." 
Internat. Dental Journ., 1890, May and June. 

Case, chancre, right side of tongue, man aged 60, from dental opera- 
tion. 

5) "Clinical notes on chancre of the tonsil with analysis of fifteen 
cases." Trans. Med. Soc. of the State of New York, 1S93. 

Fifteen cases, chancre of tonsil, among total of in personal cases. 
Bull, C. S. New York. 

Amer. Journ. Med. Sciences, Oct., 1878, p. 407. 

Case, chancre of conjunctival surface of upper eyelid. 
Bumstead, F. J. New York. 

" The Pathology and Treatment of Venereal Diseases," New York, 1S61, 
4th ed., 1S79, with R. W. Taylor; 5th ed., 1883, by Dr. Taylor, after 
death of Dr. B. References to 4th edition, representing 

1) Case, chancre of tonsil. 

2) Case, chancre of nipple, from kissing by husband. 

3) Dentists infected in practice of profession. 

4) Syphilis, probably communicated by tooth-brush (p. 432). 

5) Two cases, chancre under surface of eyelid (p. 695). 

Humbold Med. Archives? St. Louis, Mo. (Journ. Cut. Med., London, 
Vol. IV., 1S71, p. 152). 

6) Syphilis acquired from smoking a pipe. 

7) Case, chancre of finger, in a surgeon, from operation on syphilitic 
necrosis. See also Knight, Sturgis, and Taylor. 

Bureau. Paris. Hop. St. Lazare. (Interne). 

Clerc, Traite pratique des mal. ven., 1886. 

Statistics: 19 extra-genital chancres among 113 cases. 
Buret, F. Paris. 

Journ. des mal. cutan. et syph. Vol. III., 1S91, p. 646. 

1) Two cases, chancre of lip, mistaken for epithelioma, from Soler y 
Buscalla " exposicion de varios casos de sirllis, Barcelona," 1S90. 

2) Case, chancre of eye, in a surgeon, after handling a syphilitic. 
Weekly Med. Review, Feb. 20, 1S92, p. 144. 

3) Case, chancre of back in a physician, who, when partly dressed from 
a bath, examined a friend with a chancre ; he inoculated himself by 
scratching a pimple. 

Burgesius. (See Bourgeois). 

Burlet. Lyon. Hosp. Antiquaille. (Interne). (See Rollet). 

Burow, J. Konigsberg, Prof, of Laryngology. 

Monatsh. f. Ohrenheilk., etc., 1SS5, No. 5, pp. 129-138. 
Small epidemic, six cases, Eustachian infection, traced to one physician. 
(See Epidemics). 
Burtzeff, P. A. 

Meditz. Pribav. K'Moskomii Sbornikii, July, 1889, p. 66. '(British Journ. 
of Dermatology, Nov., 1889, p. 451). 
Case, chancre back of hand from washing a syphilitic patient. 
Bury. 

Medico-chirurg. Review, London, 1S29, Vol. II.. p. 464. 
Case, chancre of nipple, nurse from nursling. 
Burzew, P. (See BCrtzeff). 
Bush, J. F. Boston. City Dispensary. 

New York Med. Journ., Vol. XXXII., 1880, p. 29S. 
Case, chancre of lip, from kissing. 
Buzenet, J. J. A. Paris. Hop. du Midi. (Interne). Service of Ricord. 
"Chancre de la bouche," These de Paris, 1858. 
1) Twenty-one cases, chancre of lip, source either from abnormal coitus, 
or undetermined. 



264 SYPHILIS INSONTIUM 

2) Case, chancre of tongue, from a bite. (Obs. II.). 

3) Two other cases, chancre of tongue, one from unnatural exposure, 
the other undetermined. 

Byrne, T. Dublin. Lock Hospital. 

" Report of Army and Navy Commission," etc., London, 1867, p. 484. 
Case, nurse infected by nursling. 
Caby, E. Paris. r Hop. St. Lazare. (Interne). 

Fournier, " Etude sur la chancre cephal.," 1858. 
Seven cases of cephalic chancre, included in Fournier' s statistics. 

Caillaud, A. L. 

" Des accid. syph. consec. a la vaccin., etc." These de Paris, 1863* 
(Fournier, " Legons sur la syph. vacc," Paris, 1889, foot note p. 144). 
Cairns. Edinburgh. 

" On the dangers of obstetricians, etc." Edinburgh Med. Journ., April, 
1875, p. 887. _ 

Case, chancre of finger, in a medical man, professionally inoculated. 
Calderini, A. Milan. Osped. Maggiore. 

"Prospetto clinico sopra la malat. vener.," Milan, 1835 (Schmidt's Jahrb.). 
Statistics, of between 1000 and 1100 patients, thirty- one were infected 
through unclean linen. 

Calmette. 

Case, chancre of tonsil, from a soiled pencil (see Morel- Lav allee 6 ). 

Calvo. Paris. 

Fournier, " Etude sur la chancre cephalique," 1858. 
Case, chancre of the lip. 
Cambieri. 

Malattia di Scherlievo. Giorn. di med. prat. ; compilato dal Prof. Breda, 
Padova, 1812, Sept.-Oct., Fasc. V., p. 167. (Annali universali di 
med., Nos. 34, 35, 36; 273).* 
First writer upon Scherlie vo. 
Campana, R. Genoa. Clinico Dermo-Sifilopatica. 

" Sifilide e sihlitiche in uno triennio di clinica," 1882. 

1) Seven cases, chancre of breast, in nurses (p. 37). 

2) Case, chancre in a midwife (case of Mayer) (p. 38). 

3) Case, chancre of the buccal cavity, from cigar-stumps (case of Tan- 
turri) (p. 38). 

Campart. Paris. Hop. d. Quinze-Vingt. Eye Clinic. 

Bulletin d. 1. clinique nat. ophthal. d. l'Hosp. d. Ouinze-Vingts. Vol. 
II., 1884. 

1) Case, chancre left upper eyelid, male aged 22, source unknown, (p. 87). 

2) Case, chancre inner angle right eye, midwife, professional exposure, 
female aged 29, (p. 88). 

3) Case, chancre right upper eyelid, female aged 33, (p. S9). 

Bulletin d. 1. clinique nat. ophthal. d. l'Hosp. d. Quinze-Vingts. Vol. 
III., i885„ 

4) Case, chancre left lower eyelid, male aged 20, source unknown, (p. 48). 

5) Case, chancre left lower eyelid, male aged 38, from a bite, (p. 49). 
Campbell, J. Edinburgh. 

London and Edinburgh Med. Journ., 1844, p. 515. 
Case, chancre, nursling infects nurse. 

Canetta. Cologne. 

Koln. centr. Blatt, 1847, No. 90. (Prag. Viertelj., 1848). 

Epidemic from breast-drawing, thirty-two nurses infected. (See Epidemics). 

Cantilona. 

Cited by Demarchi, L'imparriale, 1S6S, Sept. 1. (Annal. de Derm, et de 
Syph., 1869, I, p. 158). 



ANALYTICAL BIBLIOGRAPHY 265 

Epidemic of lactation syphilis, at Astragal and Calibera. (See Epi- 
demics). 
Capuron, J. Paris. 

" Aphrodisiographie," 1S07. (Clerc " Traite prat, des mal. ven. 1 ' Paris, 
1866, p. 129). 

1) Three cases, chancres, nurses infected by nurslings (pp. 276-291). 

2) Case, chancre, child infected by the nurse (p. 290). 

3) Case, chancre of lip, in a nursling from kissing (p. 276). 

4) Case, chancre of lip, in a girl, by forced kissing (p. 113). 
Caradec, T. Brest. 

Bullet, gen. de therap, Dec, 1S51, t. 41, p. 505. 
Case, chancre, nursling infects nurse (published by Debout). 
Caramitti, A. Bologna. (Prof. Gamberini's Clinic). 
Giorn. ital. d. mal. ven. etc., 1SS2, p. 129. 

1) Four cases, chancre of lip. 

2) Case, chancre, naso-labial fold. 

3) Case, chancre of cheek, toward ear, woman of 35 years. 
Carle. Lyons. 

Lyon med., 1878, p. 417. 

Case, chancre, nursling infects nurse. 
Carleton, P. M. Surgeon U. S. Army. 

British Med. Journ , 1887, No. 12, p. 1379. 

Case, double chancre of forearm, infected by the saliva of a tattooer 
Avith tertiary syphilis. 
Carre, M. Avignon. 

Gaz. med. de Lyon, 1866, No. 9. 

Case, chancre developing in a razor cut. 

Carreras y Arago, L. 

Revista de med. y cirurg. prac't. Madrid, 1878, II., p. 241-246. 
Case, chancre inner angle right eye, new-born child. 

Carriere, G. Montpellier. 

Gaz. hebdom. d. Montpellier, July 14, iSSS, p. 327. 
Case, chancre of thumb from a bite. 

Carter, H. Vandyke. 

Fox and Farquhar " On certain Endemic Skin and other diseases of India 
and hot climates generally, including notes on Pellagra, Clou de Biskra, 
Caneotica, and Aleppo Evil." London, 1876. 

Carter, R. B. London. 

Med. Times and Gazette, London, May 23, 1863, I., pp. 532-605. 
Case, chancre, vaccino-syphilis. 

Caspary, A. Konigsberg. 

Article in refutation of the statements of Guenzberg, Vienna Foundling 
Hospital, that syphilis neonatorum was not transferred to nurses. 
Berlin klin. Wochenschr, 1S75, No. 41. 

1) Case, nursling infects nurse, she her own child (Obs. II.). 

2) Two cases, similar, nurses infected (Obs. I. and III.). 

Cassidy, J. J. Toronto. 

New York Med. Record, Jan. 29th, 1887, p. 125. 
Two cases, chancre of lip, in young women, from their fiances. 

Castel, du. Paris. 

Annales de Derm, et de Syph., 1S91, p. 404. 

1) Case, multiple chancres on arms, following treatment for scabies. 
Model in Musee de l'Hop. St. Louis. (Annales de Derm, et de Syph., 

Vol. III., Aug., 1892, p. 946). 

2) Chancre of right thumb. 



;66 SYPHILIS INSONTIUM 



Castelnau, H. de. Paris. Hop. St. Louis. 

"L* observ. et interpret, des faits en syphiliogr." Cazenave's Annales des 
rnal. de la peau, t. I., p. 8. 
Case, infant infects its grand-mother and aunt, who tended and hand- 
fed it. (See Robert, A). 
Castelo. 

Revista esp. de obtalmol. syph., etc., Madrid, 1880, I., p. 114. 
Case, chancre of right upper eyelid. 
Cataneus, Jacob de. 

Trat. de morbo gallico, 1505. Also Luisinus " De morbo gall." Lugd. 
Bat., 1728 (Bouchut, " Malad. des nouveau-nes, 5th ed., 1867, p. 1056). 
In 1523 Cataneus said: "I have seen many nursing infants infect their 
nurses." 
Caubotte. Paris. 

11 Observ. sur la contagion des maux veneriens." Journ. de med.de 
chirurg. et de pharm. , 1781, LV. , p. 227. 
Cases of syphilis insontium (original article inaccessible). 
Caudelon, J. F. Paul. 

" Des diff. modes de transm. de la syph. chez le nouveau-ne." These de 
Paris, 1852, p. 28*. 
Cavazzani. 

La Riforma med. Jan. 1891, p. 171. (Annalesde Derm, et deSyph., 1S91, 
p. 625). 

1) Case, chancre, anterior pillar of fauces. 

2) Case, chancre of finger, in a physician, 50 years of age, after 
operation on syphilitic. 

Cayla, A. Paris. Hop. Cochin, service of Moutard-Martin. 
La France medicale, 1881, II., p. 532. 

1) Case, chancre of lip. 

"Deux observ. de l'arthrite syphil. second." Annales de Derm, et de 
Syph., Paris, 1887, p. 341. 

2) Case, chancre of gum, source unknown (service of Fournier). 

Cazenave, A. Paris. Hop. St. Louis. 
" Traite des Syphilides," Paris 1843. 

1) Four cases, chancre of lip (two of Biett) (pp. 108, 109, 486). 

2) Two cases, nurses infected by nurslings (pp. no, 281). 

3) Two cases, physicians infected in operations (pp. 81, 491). 

4) Two cases, physicians infected in obstetrical practice (pp. 81, 112). 

5) Case, midwife infected in obstetrical practice (Biett) (p. 492). 

6) Case, probable chancre of fauces, woman from husband (p. 386). 

7) Cases, infection from sleeping with syphilitics (cases observed by 
Lagneau, Lucas Champiomere and Biett) (p. 385). 

8) Epidemic, m Switzerland, by charlatan bleeding with lancet cleansed 
with saliva (Daguerre) (p. 113). 

Annales des mal. de la peau et de la Syph., Vol. III., 1 850-1, p. 283. 

9) a. Nurse, infected by nursling; b. She infects a second nursling; 
c. This child infects its mother ; and also d. Infects her sister, aged 
3 years. 

Revue de med. de Paris, 1852, p. 409. 

10) Case, nurse infected by nursling. 
(Cited by Diday, " Infantile Syphilis," Sydenh. edit, 1859, p. 179). 

n) Suspected exception to Colles' law; mother, ulcers on nipples after 
nursing her own syphilitic child ; father syphilitic. 

Ceccaldi. Constantine. 

Rev. medico-Chirurg. de Paris, Feb., 1S53, XIII., p. 121. 

Three cases, vaccinal syphilis, two children of one family, and 
a third, from the same vaccinifer, 1S45. 






ANALYTICAL BIBLIOGRAPHY 267 

Cederskjold, P. G. 

Utdrag ur Sammandrag of Berattelser infran Lakarne i hela Riket om 
veneriska Sjukdomen dess Forandringar och urarter. Stockholm, 
1813.* (Quoted by Boeck, " Traite d. 1. Radesyge,"iS6o. p. 44). 
A study of Radesyge. 
Cehak, F. 

Verhandl. der Wien. Derm. Gesell., Sitz., Mar. 11, 1891. Archiv f. Derm, 
u. Syph. Vol. XXIII. , 1891, p. 821). 
Three cases, chancre of lip, two of upper and one of lower. 
Cenas. 

Cases reported by Stourme, q. v., pp. 45-47. 

1) Three cases, chancre of lip, one in a woman, from husband. 

2) Case, chancre, mucosa of cheek. 
Cerasi, F. Rome. 

"Communication of syphilis by the milk." Giorn. Med. di Roma, 1S66, 
(Giorn. ital. d. mal. ven., etc., 1866, II., p, 47). 

1) Case, nurse in florid syphilis, infects two nurslings, as author con- 
tends, through her milk (p, 47, Obs. I. and II). 

2) Case, mother recently infected, her nursling gets the disease. 
(Obs. III). 

3) Case of Brunelli's, same nature as foregoing. 
Lo Sperimentale, 1877, XL., 117. 

Same subject as above. 
Cerioli, G. Cremona. 

Annali universah di med., Milan, 1824 t. XIX. (De la syph.-vaccin. 
L'Acad. de med., Paris, 1865, p. 222). 

1) Epidemic of vaccino-syphilis at Cremona, 1821. (See Epidemics). 
"Delia possibilita di commun. la sifil. col. mezzo di vaccin," 1846. (De 

la syph. vaccin. L'Acad. de med., Paris, 1865, p. 222. 

2) Epidemic of vaccino-syphilis at Grumello, 1841. (See Epidemics and 
also Marcolini and Tassani). 

Gazette med. de Milan, Oct., 1843,* (Quoted by Petit, "Trans, d. la syph. 
par la vaccin.," 1867 p. 10). 

3) Vaccino-syphilis. 
Cerisi, L. 

" Syph. commun. par la vacc." L' union med., Paris, 1S61, No. 134, 
P- 259. 

" Nouveaux reseignm. sur les accid. de prop. syph. par la vacc a 

Rivalta." L'union med. Paris, 1862, No. 21, p. 322, and Gaz. hebdom, 
Paris, 1862, No. 16. 
Accounts of the vaccino-syphilitic epidemic at Rivalto, reported fully 
Pacchiotti, q. v. 
Chaboux, F. Paris. 

These de Paris, 1875, ° bs - XIII. 

1) Case, chancre, nurse from nursling. 

2) Case, weanling from preceding, its mother, infected per os, through 
pre-mastication of its food. 

Chabrely, B. Bordeaux. 

Journ. de med. de Bordeaux, Jan., 1859, 2d Series, IV., pp. 19-31. 
Two cases, nurses affected by nurslings. 

Chadzynski. Lembourg, Galizia. 

(Rizat, " Manuel des mal. vener.," Paris, 1882). 

Case, nurse infected by nursling, acquires multiple chancre of the breast 
and areola (p. 310). 

Chambay, E. Paris. 

"Gaz. des Hop.," Paris, 1S65, No. 178, p. 45. 
Case, child infected by its mother. 



268 SYPHILIS INSONTIUM 



Charayron, C. Paris. 

These de Paris, 1877, p. 11. 

Case, child infected at age of 8 months (service of E. Vidal). 

Charlouis. 

Viertelj. f. Derm. u. Syph., 1881, p. 431. 
On "Yaws." 

Charpentier. Brussels. (Prof. Thiry). 

La Presse med. Beige., Bruxelles, 1868, XX., 14. 
Two cases, nurslings infected by nurses. 

Charriere. Paris. 

Archiv. gen. denied., 1862, t. II., p. 327 (cited by Fournier, "Syph. et 
Mariage," (p. 39). 
Case, two-year-old child, infected per os, from father, kissing. 

Chartier. Paris. Hop. St. Louis. (Interne). Service of Fournier. 
Published in Morin's These de Paris, 1888, p. 87. 
Case, chancre of lip, at commissure. 

Chassagny, M. 

" De la prophylaxie de la contag. des accid. prim, et second, de la syphilis 
chez les ouvriers Souffleurs de Verre." Gaz. hebdom. de med. et de 
chir., Paris, 1862, IX., p. 793. 
Review of subject of glass-blowers' syphilis, no cases. 

Chassaignac. Paris. Hop. St. Antoine, Surgeon. 

Bull, de l'Acad. de med. de Paris, 1869, XXXIV., p. 783. Also (Trans. 
London Obstetrical Society, Vol. V., p. 196). 
Case, three chancres of arm, in two-year-old child, from vaccination. 

Chaumier, E. Tours. 

Le Poiton medical, 1891, No. 5, p. 103. 

Case, chancre of anus, infant 17 months, from sponge. 

Chauvet, C. Paris. University Professor Agrege. 

" Sur l'influence de la syphilis sur les maladies du systeme nerveux cen- 
trale." These d' aggregation, Paris, 1880. 
Case, chancre of lip (Proust, Ballet, Lariboisiere, 1879) (p. 64). 
Cheadle. London. St. Mary's Hospital. 

(Cited by Jullien, from Lyon medicale, 1872, I., p. 409). 

1) Case, vaccino-syphilis. 

" Three cases of late or tertiary syphilis in children," British Med. Journ., 
London, 1880, I., p. 204. 

2) Case, infection in child. 

Cheminade, G. Bordeaux. Hop. St. Jean. (Interne). 
Annales de Derm, et de Syph., 1888, Vol. IX., p. 535. 

1) Case, chancre of right lateral cervical region, from razor cut. 
L'union medicale, 1889, XLVIIL, No. 93, p. 157. 

2) Case, chancre of breast, nurse from nursling. 

del Chiappa, G. B. Pisa. Assistant to the Skin and Venereal Clinic. 

' ' II primo triennio della clinica Dermo-sifilopatica di Pisa, diretta dal 
Prof. Celso Pellizzari." Milan, 1890. (Giorn. ital. d. mal. ven., etc., 
1889, p. 139). 
1) Three cases chancre of the breast and one of the chin, observed 
in the clinic during the years, 1885-6-7 (p. 10). In all, eight women 
were seen who had acquired syphilis from infants whom they were 
nursing; of the children, four were from private families, and four 
foundlings (p. 19). 
Report of cases treated in the Dermo-syph. Clinic in Pisa, in 1880. 
Riforma med., Nov., 1S91. (Monatsh. f. prakt. Derm. Bd. XIV., 
No. 8, p. 322). 



ANALYTICAL BIBLIOGRAPHY 269 

2) Case, chancre upper lip. 

3) Case, chancre lower lip. 

4) Multiple chancre of forehead, lower eyelid, and chin. 
Chiari, O. Vienna. Prof, of Pathological Anatomy. 

" Laryngoscop. Befund bei d. Fruhform. d. Syph." Archiv f. Derm, 
u. Syph., 1882. 

1) Case, chancre of lip, no mention of origin (p. 499). 

2) Case, of Sommerbrodt's, chancre of lip (p. 500). 
Chipier. Paris. Hop. du Midi. (Interne). 

(Rizat, "Manuel prat. d. mal. ven." Paris, 1S82). 

Case, Simonet's, Hop. du Midi., chancre of nuchal region, from direct 
exposure in carrying a person (p. 346). 
Chisholm, J. Baltimore. 

Maryland Med. Journ., June, 1882, p. 81. 

Case, chancre of lower lip, in a young girl, from a kiss. 
Chochlow. 

(Seen in clinic of Dr. Mauriac.) Vratsch., 1SS1, No. 35, 43. 

1) Case, chancre of cheek, from razor cut. 

2) Case, chancre of index finger, lcf : hand, from blow on the teeth of 
an assailant who had syphilis. 

Chrestien, H. Montpellier. Prof, of Therapy. 

(These cases cited by Legrand, " De Tor et du mercure," probably from 
"Lamethode iatroliptique," 1S11). 

1) Case, of Niel's, nursling infects two nurses (Legrand, Obs. 129). 

2) Case, of Menard's, woman infected in pregnancy; new-born child 
infects nurse; mother infects her next youngest (Obs. 178-180). 

3) Case, of Simoxeau, chancre of tongue, from kissing (Obs. 377). 

4) Case, of Sarda, chancre of lips (Obs. 392). 

5) Case, of D almas, nursling infects nurse (Obs. 403). 

Christie, James. 

McCall Anderson's Treatise on Diseases of the Skin. London, 1887, pp. 

285, 393- 
"Delhi boil," " Framboesia," etc. 

Chudnoski. Tiflis. 

Proceedings Med. Soc. of the Caucasus (London Lancet, 1886, II., p. 988). 
Case, chancre of chin, developing in a razor cut. 

Churchill. London. Westminister Dispensary. 
Medical Times and Gaz., 1872, I., 160, 190. 
Case, chancre of thumb, in a medical student, from palpation of sores. 

Claeys, G. Ghent. 

Annales de la soc. med. de Gand, 1883, LXI., p. 206. 
Case, chancre of eyelid, etiology unknown. 

Clarke, A. London. Middlesex Hospital, Surgeon. 
Lancet, London, 1872, Aug. 2, p. 153. 
Case, nurse infected by nursling, chancre left nipple. 

Clarke, B. London. St. Bartholomew's Hospital. 
Lancet, London, 1882, II., p. 702. 
Case, chancre of lip. 

Clary and Guary. 

Bull de l'Acad. imp. de med., 1866-7, P- 1039. (Cited by Fournier, 
11 Syphilis Vaccinale," 1889, p. 219). 

1) Epidemic of vaccino-syphilis at Cardeillac, 1866: Of 22 vaccinated 
from one child, 13 acquired syphilis. (See Epidemics). 

2) Two cases, chancre of the breast, from above children, one in child s 
mother and one in a wet-nurse. 



SYPHILIS INSONTIUM 



Claude. 

" Etude sur la syphilis du sein." These de Paris, 1886. (Annal. de Derm. 
et de Syph., 1886, p. 774). 
Case, chancre of breast, in 65-year-old woman, removed as an 
epithelioma. 
Clement. Frankfurt. 

Deutsche Klinik, 1853, p. 157. 
Case, of vaccino-syphilis. 
Clement. Lyons. 

Gaz. med. de Lyon, 1865 (XVII), p. 528. 
Case, chancre of the cheek. 
Clements, B. A. United States Army Service, Surgeon. 
Amer. Journ. Med. Sciences, 1861, vol. XLII., p. 40. 

Case, chancre of lip, husband infects wife by a tooth-wound.' 
Clerc, F. F. Paris. Hop. St. Lazare. 
Traite des mal. vener., Paris, 1866. 

1) Statistics, St. Lazare; in 113 chancres, 19 extra-genital; lip 11, nose 
3, forehead 2, tongue 1, fauces 1, neck 1 (collected by Bureaux). 

2) Disp. de salub. publ. ; among 403 chancres, 7 extra-genital ; lip 5, 
tongue 1, eyelid 1. 

3) Personal cases, in 21 years, about 50 extra-genital; lip 30, eyelids 8, 
tongue 2, chin 2, cheek 1, gum 1, fauces 1, septum nasi 1, scrotum 1 
(from wearing apparel). 

Clerici, G. Milan. Osp. St. Catarina, Director. 

Annal. univer. di med., Feb., 1885 July, Aug., Sept., 1856 (Schmidt's 
Jahrb.). 
Twenty-seven nurses infected by nursing, in Osp., 1854. 
Clerval. Paris. Hop. Quinze-Vingt. 

Bull. d. 1. clin. nat. ophthal. d. Hop., 2— V., 1887, V., 90. 
Case, chancre of eyelid. 
Cline. Montreal. 

Canada Med. and Surg. Journ., Aug., 1875. 
(Report of case of Fen wick, q. v.) 
Case, chancre of eyelid. 

Closa. 

"Chancro sifilitico del borde libre del parpado" — Oftalmol. prat. — Madrid, 
1882-3, I., p. 151-153.* 
Case, chancre of the eyelid. 

Closmadeuc, G. and Denis. Auray. Dep. of Morbihan. 

Depaul, Bulldel'Acad. de med., XXXII., p. 1039, and " Examen. crit. 
des docum. rel. ai'epidemie de syph. vac d' Auray," 1866, Paris, 1871 
(Fournier 1 , "Syph. vaccin.," p. 221). 
Epidemic of Vaccino-syphilis at Auray. 

Clossius, C. F. Tubingen. 

" Ueber die Lustseuche," 2d ed., 1799. 

1) On p. 41 et seq. are found many references to Albinus, Sommering 
and others. 

2) Case, inoculation by the finger used to raise a fallen uvula (p. 49). 

Clowes, Wm. London. St. Bartholomew's; Surgeon to the King. 

' ' New and approved Treatise concerning the cure of the French Pokes," 

I575- 

1) Three cases of midwives, professionally infected. 

2) Case, seemingly of syphilis acquired in infancy. 

Cocchi, B. Milan. 

Gaz. med. Lombard, 1858, No. 10. 

Two cases, nurses infected by nurslings. 



ANALYTICAL BIBLIOGRAPHY 271 

Cochez. Paris. Hop. Cochin- (Service of Despres). (Interne). 

Paris medicale, 1880, No. 78, also cited in Guignard's These de Paris. 
Two cases, chancre of chin, each in site of razor wound ; one a triple, 
the other a double chancre. 
Cochran, A. W. 

Notes on the measures adopted by Government between 1775 and 1786 
to check the St. Paul's Bay disease. Trans. Lit. and Hist. Soc, 
Quebec. 1854, IV., 139-148*. 
Coesfeld. 

Deutsch. med. Wochenschr. Berlin, 1884, X., (p. 404). 
Case, chancre of tip of right index finger. 
Cohansen, S. E. E. Treves. Univ. Prof, of Medicine. 

"Lues venerea per manus obstet. propagata." Acta Nat. Cur., 1744, 

VII., 25I (GlRTANNER, No . 987). 

Epidemic of obstetrical propagation of syphilis. 
Cohen, J. Solis. Philadelphia. 

" Diseases of Throat and Nose." Phila.. 1S79, 2 & e &- 
Case of Eustachian-catheter infection, ending fatally (p. 19). 
Cohn, H. Breslau. University Professor of Ophthalmology. 
Schubert, " Syphilit. Augenkrank." Berlin, 1881, p. 82. 
Case, midwife infected in delivery. 
Cold. 

Ugeskrift for Laeger, 1859, No. 24. 

1) Family epidemic, involving three infants and four adults, one of 
them 

2) Old woman, infected by chewing food of infant. 
Colle, J. Padua. University Prof, of Medicine. 

" Notitia et medela singularis adversus Neotericos, de morbo Gallico . . . 
et ejus sympt." Venetiis, 1628. 
Case, one of the counts of Fano, supposed to have been infected by his 
brother, from sleeping in same bed during his illness. 
Colles, Abr. Dublin. 

" Practical observations on the Venereal disease, and on the use of mer- 
cury." London, 1837. 

1) Case, medical man infects his betrothed, by kissing (p. 13). 

2) Case, nurse infected by nursling, infects her own infant (p. 271). 

3) Case, servant girl, aged 13, from infant. 

4) Family epidemic, five infected, four chancres of lip, one of breast 
(p. 294). 

5) Surgeon infects several parturient women, from secondary sore on 
finger, excited by trauma, (p. 14). (Healey). 

Dublin Med. Press, Oct., 1844. (Annales de mal. de la peau, 1845, pp. 
222, 308). 

6) Case, infection of child from sleeping with a syphilitic woman. 

7) Case, infection, nurse from above child. 

8) Infection of several women from a syphilitic accoucheur, (p. 308) 
(probably same as 5). 

Collier, S. R. Wimbledon, England. 

British Medical Journal, 1889, I., p. 1114. 
Two cases, mother and sister, aged 12, infected by a syphilitic woman, 
or her child. 
Colombini, P. 

Del sifiloma iniziale dell amigdale. Riform. med., 1892, 50, 51.* (Archiv 
f. Derm. u. Syph.,. Vol. XXIV., 1892, p. 692). 
Conte, E. 

II Progreso medico, Dec. 1, 1889. 

Case, chancre of the lip, from cigarette, lighted by a syphilitic. 



272 SYPHILIS INSONTJUM 



Cooke, T. W. London. Westminister Hospital. 
Lancet, Aug., 1857 (also Mason, q. v., Obs. II). 

1) Case, chancre of lip. 

Med. Times and Gaz., i860, I., p. 563. 

2) Case, boy, 7 years, infected by mother, who occupied same bed. 
Cooper, A. London. Surgeon Westminster General Dispensary. 

"Note on extra-genital contagion." Lancet, 1890, II., p. 866. 

1) Case, chancre alse nasi, girl 10 years old, no history of contagion. 

2) Case, chancre right nipple, child iy z years old. 

3) Case, chancre left side of tongue, man 28 years old. 

4) Case, chancre of hypogastrium ; no exposure for 7 months ; had 
scratched himself there when in public bath, two weeks previously. 

5) Case, chancre of chin; alleged re-infection; syphilis seven years 
previous^. 

6) Case, chancre of lip, from drinking beer after companion with 
mucous patches. 

Cooper, J. Foster. 

Guy's Hosp. Reports, London, 1872, 3d series, XVII., p. 257. 
Case, chancre upper eyelid, in male of 20 years. 
Cooper, S. London. University Hospital. 

" Lectures on Syphilis" (Behrend's Syphilidol., L, 1839, p. 358). 
Case, chancre of finger, in a medical man, professionally exposed. 
Coote, H. London. St. Bartholomew's Hospital. 

A report treatment of syphilis, London, 1857. 

1) Case, infant infected from nurse (p. 132). 

5) Case, girl, aged twelve, infected from kissing sister, hereditary 
syphilis. 
Report, Army and Navy Commission on Venereal Disease. London, 
1867. 

3) Case (Coote, himself), inoculated, right middle finger, opening a bubo 

(P- 343). 

4) Case, own re-infection, twenty years later, left forefinger (p. 343). 
Clin. Soc. Transactions (Lancet, 1861, I., p. 288). 

5) Case, chancre upper lip. 
Corcelet. Grenoble. 

(See Diday, "De la reinfection syphilitique," 1862, p. 17). 
Case chancre of the lower lip. 

Cordier. Lyons. Hosp. de l'Antiquaille, Surgeon. 
Cases reported by Stourme, q. v., pp. 71-76. 

Cases, chancre of the lip 7 ; of tonsil 3 ; of gums 1 ; per os, locality not 
given, 1. Total 12. 

Cornarius, J. Frankfurt. Univ., Prof, of Medicine (at Jena and Marbach). 

" Liber Tonsil, med seq. observ. med." Lipsise, 1595. (Gruner's, 

" De morbo Gallico scriptores," p. 258). 
Case, inoculation by wet-cupping, chancre in situ, observed before 1558. 

Corrigan. Dublin. Physician to the Charitable Infirmary. 
London Med. and Surgical Journ., 1835, VII., p. 715. 

Clinical lecture on a case of " button scurvy," said to have been acquired 
by sleeping with a man with syphilis. 

Cory, R. 

Reported by Hutchinson 14 (see also Fournier, "Syph. vaccinale" (p. 15), 
(foot-note), inoculated himself, after three unsuccessful attempts, with 
syphilis, with vaccine lymph from syphilitic child. 

Coste\ Berlin. 

" Observations pratiques sur les malad. vener.," Berlin, 1760. 
Case, chancre of rectum, from introduction of an infected finger. 



ANALYTICAL BIBLIOGRAPHY 273 



Coste. Paris. 

Gazette d. Hopitaux, Dec. 11 and 16, 1873. 
Three cases of vaccino-syphilis. 
Couper. London. London Hospital. 
Lancet, London, 1870, II., p. 603. 
Case, chancre of lip. 
Coutagne, E. Lyons. 

Gaz. med. de Lyon, Mar. 1, 1866. 
Case of Eustachian infection ; probable chancre of both tonsils. 
Coyttarus, J. Paris. 

"De febre purpur. epidem." Parisiis, 1578, cp. III. 

1) Case, servant, infected through cast-off clothing of a syphilitic person, 
(pp. 28, 29). 

2) Case, chancre of thumb in her sister. 
Cozzolino, V. 

1) "Sifilosi delle tonsille." Bollett. d. clin., Milano, 1888, V. pp. 97-107.* 
Riv. clin. dell. Universite di Napoli, 18S9, 1-2. (Archiv f. Derm. u. Syph. 

Vol. XXL, 1889, p. 598). 

2) Chancres of the nose, mostly from unclean instruments, especially 
from Eustachian catheterization. (No cases given). 

Craigie, D. Edinburgh. 

Elements of the pract. of phys., Edinb., 1837, I., 668-726. 
Treats of Sibbens, Yaws, Radesyge, etc. 

Crawford, C. H. 

Medical Times and Gazette, London, 1873, I., p. 531. 
Case, vaccino-syphilis. 
Creighton, C. 

The natural history of cow-pox and vaccinal syphilis, London, 1887. 
Cripps, H. London. St. Bartholomew s. 

" Proc. Med. Soc. of London," Jan. 24, 1887. British Med. Journ., 1887, 
I., p. 212. 

1) Statistical, in 1886; saw 14 chancres in unusual sites. 

2) Case, chancre of eyelid, one of above, a 70-year-old lady, from her 
grand- child. 

British Med. Journ., Apr. 16, 1892, p. 815. 

3) Case, chancre face, between lip and chin, in middle aged man, from 
razor cut. 

Critchett. London. Moorfield's Eye Infirmary. 

Med. Times and Gazette, London, Sept. 1857, p. 272. 
Case, chancre lower eyelid. 

Cullerier, Auguste (1805-1874), son of F. A. G. Paris. Hop. Midi and 
Lourcme. 
" Mem. sur la contag. syph. entre 1. nour. et 1. nourrissons." Paris, 1S54. 
(Also L' union med., 1854, pp. 459, 463, 471). 

1) Case of syphilis alleged to have been contracted from nursing. 
"Precis, iconograph. des mal. vener." Paris, 1862-1S66 (Bumstead's 

transl., Phila., 1868). 

2) Case, chancre of vulva, from mother, by use of same sponge (p. 43). 

3) Two cases, chancre of eyelid (plate 41, figures 2 and 3). 

4) Case, chancre of eyelid (seen by Mackenzie in C.'s clinic). 

5) Case, chancre of tonsil (reported by Le Gendre, from notes by 

M ARTEL): 

6) Case, chancre of lip, in medical student, from infected lead-pencil 
(p. 48). 

7) Case, chancre of lip. 

8) Case, chancre of lip, from drinking-glass (case of Hillairet). 
(See Beyran, Bucquoy and Martelliere). 

19 



274 SYPHILIS INSONTIUM 

Cullerier, F. A. G. (i 782-1 841), nephew of Michael Cullerier. Paris, Hop. 
des Veneriens, Surgeon-in-Chief. 
See Lucas-Championniere, who published C's cases in his "Traite, etc." 
1836. 
Cullerier, Michel (oncle, 1 758-1 827). Paris, Hop. des Veneriens, Surgeon-in- 
Chief. 
Journ. gen. de med. de chirurg., et de pharm., 1816 (LV), p. 32. (Cited 
by Roussel: " De la syph. tertiare," Paris, 1881, p. 64). 

1) Case, chancre, nurse from nursling (1797). 

2) Case, chancre of lip, from an attendant, through kissing or bathing 
with saliva (181 6), (p. 33). 

Reported by Cazenave. 

3) Case, chancre of lip, from kissing. 

Also see Renard, Lucas-Championniere ("Traite," etc., 1836), Diday, etc., 
(Dictionnaire des Sci. med. par une Soc. de med. et chir. Paris, 
1813, IV.). 

4) Case, chancre external auditory meatus (p. 516). 

5) Case, chancre of pharynx with necrosis of vertebrae (p. 527). 

6) Case, chancre on thyroid cartilage (p. 528). 
Cunier, F. Brussels. Founder of the Annales d'oculistique. 

"Recherches stat. sur les mal. ocul. ," Annales d'ocul. 

1) Case of Breyer, chancre of eyelid in child 3^ years old, received 
from caresses of a woman (t. iv., p. 238). 

2) Case of Hairion, q. v., chancre of eyelid. 

3) Case, chancre of eyelid in a 17-year-old woman (t. XVI., p. 166). 

4) Case, chancre of eyelid in infant from kiss of prostitute with a chancre 
of the lip (t. XVI., p. 208). 

Cusack, J. Dublin. Lock Hospital, Surgeon. 

Dublin Quart. Journ., 1846, p. 337 (also Colles "Treatise," 1837, p, 273^ 

1) Family epidemic. 

a) Case, chancre of breast, from nursling. 
3) Case, infant infected by wet-nurse. 

c) Case, child infected per os, from mother. 

d) Case, child infected per os, from mother. 
c) Case, servant-maid, infected per os. 

2) Case, chancre, peri-anal, 18-months child, infected by nurse. 

3) Case, chancre of thumb, from carrying a syphilitic child. 

4) Case, infection through bedding of above child. 
Cutter, J. C. Philadelphia. 

Phila. Med. Times. 1879-80, X., p. 299. 
Case, chancre within nostril. 
Dabry, P. 

La medicine chez les Chinois, Paris, 1863, p. 263. 

Syphilis among the Chinese. " Yang-Mey-Tchonang." 
Daehne, J. G. Leipzig. 

" Osservachione pratiche sopra il mal. veneree." German edition. 
Wien, 1 791 (notes by Cirillo), 
Case, chancre of lip, from holding infected quill-pen in mouth (p. 9). 

Daguerre. 

(Cited by Cazenave, q. v., without references). 

Group of cases, infected by venesection, scalpel cleansed with operator's 
saliva. 

Dall'Acqua. 

Epidemic of vaccino-syphilis (see Grancini and Dall'Acqua). 

Dalmas. Montpellier. University Professor. 

Observation in Chrestien, q. v. and Legrand. (Obs. 403). 
Case, nursling, congenitally syphilitic, infects nurse. 



ANALYTICAL BIBLLOGRAPHY 275 

Danielssen, D. C. Bergen. Comrrmn Hospital. 

" Syphilisation anvendtmod Syphilis og Spedalsked." Bergen, 1858. 

1) Case, chancre, woman infected by nursling; later, own child receives 
disease (p. 47-50). 

2) Case, recent syphilis in child of 6 years ; parents syphilitic a year 
before (p. 50). 

3) Case, recent syphilis in a young woman, assigned to infected bedding 
(P- 5o). 

4) Case, recent syphilis in young woman ; in service where the people 
were syphilitic (p. 51). 

5) Case, probable chancre of toiisil in an old woman who had been foster- 
ing an infant (p. 57). 

6) Case, infant who infected preceding and had received chancre of 
mouth from a midwife who first fed him (p. 58). 

7) Case, chancre of nipple, wet-nurse of preceding (p. 59). 

8) Case, recent syphilis, in servant, began m throat; her mistress 
syphilitic (p. 61). 

9) Case, recent syphilis in i-year-old infant; mother same (p. 63). 
Danyon. Paris. 

Case, Eustachian infection (see Bucquoy 2 also Cullerier). 
Dardel, A. Aix-les-Bains. 

(Statistics (personal) of Clerc, q. v., "Traite etc., 1866; p. 104). 
Case, chancre of eyelid. 
Davis, C. E. Chicago. 

Chicago Med. Journ. and Examiner. 1876; p. 440. 
Case, nurse infected by kissing her nursling. 
Dawosky. Dresden. 

" Mittheilungen aus der Syphilis Praxis." Memorabilien, Heilbronn, 
1876. No. 10. 

1) Case, chancre of finger in a midwife (p. 435). 

2) Two cases, syphilis from the same midwife above mentioned (p. 433). 
DeAmicis, T. Naples. University, Prof, of Dermatology and Syphilis. 

II movemento med. chirurg., 1877 (IX.), No. 33. 

1) Case, nurse infected by nursling, infects 

2) Case, nursling, her own child. 

3) Case, nurse infected by nursling, the child of case 1. 

" Sulla Syph. ossea e muscolare," etc. II movemento med. chirurg., 1880, 
II., p. 460. 

4) Two cases, adults with bone syphilis infected in infancy by wet- 
nurse. 

Annales de Derm, et de Syph., 1881, p. 786. 

5) Case, chancre of left cheek. 

6) Case, chancre of nipple and chin in same woman. 

Dease, W. Dublin. St. Nicholas and Catharine Hospitals, Surgeon. 

" Heilart der Lustseuche," translated by Michaelis, Jena, 1790. 
Case, nurse, infected by nursling (p. 133). 
DeBeck, David. Cincinnati. 

" Hard chancre of the eyelids and conjuctiva," Cincinnati, 1886. 

1) Case, chancre, right lower eyelid, from contact in bed with male 
friend. 

2) Tabulated details of 85 cases from literature. 

3) Tabulated details of 8 cases, from personal communications, from 
Ayres, i; Galezowski, 4; Juler, 2; Sattler, i. q. v. 

Dechaux. Montlucon. 

Gaz. med. de Lyon, 1867, Nos. 15-T6. 

Epidemic of glass-blower's syphilis at Montlucon, 1S6S-1869. (Guinand 5 ). 
Defaucambourge. Gien. 

Case, nurse infected by nursling. (G. Lagnf.au 3 , q. v.). 



276 SYPHILIS INSONTIUM 

Deffernez. Jumet, Belgium. 

Bulletin de l'Acad. Royale de med. de Belg., Bruxelles, 1885, 3d series, 
XIX., pp. 364. and 476. 
Syphilis in glass-blowers. 
Deguerre, J. J. S. 

Essai sur 1' inocul. du virus syph. These de Paris, an. XI. (1803) 
P- 43-* 
Delapersonne. Paris, Hotel Dieu, Chief of Surgical Clinic. 
Archiv. d'ophthalmol., 1880-1881, p. 499. 

1) Case, chancre of eyelid, involving caruncle. 

2) Case, chancre of left lower eyelid. (Service of Dr. Panas). 

3) Case, chancre of right lower eyelid. (Barthelemy 2 ). 
Del Chiappa, G. B. (See del Chiappa). 

Del Greco. Florence. 

Case, chancre of leg, inoculation by an electric brush (see Peliz- 
zari, C 20 ). 
Del Monte, M. Naples. Professor Ophthalmology at University. 
II movimento med.-chirurg., 1882 (De Beck, p. 42). 

1) Case, chancre of eyelid, medical man (p. 155). 

2) Case, notes by Sbordone, medical man, chancre of eyelid, digital 
auto-infection (p. 157). 

Delore. Lyons. Hop. de la Charite. 

(Fournier " Nourrices et Nourrissons," p. 9). 

Case, chancre, nurse infected from nursling: nurse in turn infects her 
husband. 
Delpeche, E. Montpellier. Univ. Prof, of Surgery. 

Clin, chirurg. de Montp. , 1826 (Lawrence, " Lect. on Surgery," 1830). 

1) Case, surgeon infected on ringer, from rectal operation. 
(Cited by Oesterlen, " Ven. Contagion," 1843, p. 67). 

2) Case, chancre of chin, in site of razor wound. 
Demange, E. Nancy. Prof, of Medicine. 

"Chute spontane des dents et crises gastriques— chez les ataxiques." 
Revue de med., 1882 (Fournier, " Period. preatax. du tabes"). 
Case, chancre of lip, ataxia 30 years later. 
Demarchi. 

L'Imparziale, Sept. 1. 1868. (Annales de Derm, et de Syph., 1369, p. 

158, Giorn. ital. d. mal. ven., etc., 1869, I., p. 243). 
Epidemic of Capistrello and Castellafiume (see also Tanturri, Ruggiere. 
Durante, Selli, also Epidemics). 
Demeaux. (See Laroyenne). 
De Meric, V. London. Royal Free Hospital. 

"On some peculiar modes of transmitting syphilis in married life." 
British Med. Journ., Jan. 24, 1874. 
Case, chancre of tonsil, husband infected from wife. . 

Demets, A. Ghent. 

Annales de la Soc. Med. de Gand, 1884 (t. LXII), p. 147. 
Two cases, chancre of eyelids, etiology unknown. 

De Molines. See Des Molines. 

Denis. (See Closmadeuc). 

Denis-Dumont. Caen. Professor Ecole Militaire. 
41 De la Syphilis," Paris, 1880. 

1) Case, infection of a military man through a tobacco-pipe (p. 76). 

2) Case, chancre of the finger, in a midwife (p. 186). 

Denti. 

Annali d'ottalmologia, XII., 1883, p. 567 (De Beck, p. 44). 






ANALYTICAL BIBLIOGRAPHY 277 

Case, chancre of lower cul-de-sac of left eye, from a nail-wound of a 
syphilitic nursling. 

Depaul. Paris. Director of vaccine service. 

" De la Syph. Vacc." Acad/ imper. de med, Paris, 1865, pp. 59, 84, 200. 

1) Family and lactation epidemics of Viani, Rodet, Marone, Herard, 
and Chassaignac, q. v. 

Bull, de l'Acad. de med., 1S66, p. 1047 (Fourmer, " Syph. vacc," p. 191), 

2) Nine cases of vaccinal syphilis. 
Bull, de l'Acad. de med., Paris. 

3) Twenty-three cases of vaccinal syphilis, 1867 (p. 619). 

4) Two cases, vaccinal syphilis, reported by Dr. Zalloxis, of Greece, 
1869 (p. 1017). 

5) Case, vaccinal syphilis reported by Dr. Vicherat, of Nemours. 

6) Case, vaccinal syphilis in a child, from nursling, nursed by 

7) Case, chancre of breast in mother of last case ; subsequently her hus- 
band and three other children were infected, 1S69 (p. 1103). 

Discussion on vaccinal syphilis, defending Bardinet's work on " Un vacc. 
syph.," 1869 (p. 1171). 

Depaul and Roger. 

Bull, de l'Acad. de med. de Paris, XXXI., p. 88S. 

Epidemic of vaccinal syphilis at Morbihan, 44 infected. (See Epidemics). 

Descroizilles. 

La France medicale, 1887, I., p. S3S. 

Case, chancre of the anus, in boy 12 years old, pederastic. 

Desjardins. A. Algiers. 

L'Akbhar. (Journ. d' hygiene, 1SS1, p. 399). 
Epidemic of vaccinal syphilis, fifty-eight soldiers inoculated from a 
single vaccinifer. (See Epidemics). 

Desmarres, L. A. (perel. 

Traite theorique et pratique des mal. des yeux." Paris, 1854, t. I., p. 621. 

1) Case, chancre of eyelid, medical man from coughing of a syphilitic. 

2) Case, chancre of eyelid in midwife. 

3) Case, chancre of eyelid in an adult; in both, cause unknown. 

Desmet, E. Brussels. Univ. Prof, of Dermatology and Syphilis. 
La presse med. Belg., 1S81 (XXXIV) (p. 73). 

1) Case, chancre of breast. 

" Ueber die Syph. der Glasbloser" La Clinique, Bruxelles, 1SS7 (Novem- 
ber). Monatsh. f. prakt. Derm., 1S8S. p. 3S6). 

2) Case, chancre in a glass-blower, infected per os. 

Des Molines. Paris. Hop. Lourcine. (Interne). (Service of Martineau). 

Statistics of 128 cases; lips 8, fauces 2, nipple 2 (see Martineau and 

BlNET). 

Desnos, E. Paris. 

L'union mwl, 18S9, I., p. 454. 

1) Case, chancre of the tongue, in cashier from infected bank-notes. 
Diet, de med. et de clururg., prat. VII., p. 149 (Compt. rend. Soc. Med. d. 

Lyon, 1861-2, pp. 45, 70). 

2) Statistics; out of 77 chancres of the mouth, there was only one 
chancre of the tonsil. 

Despagnet, F. Paris. 

Receuil d* ophthalmol., 1881, p. 521, 

1) Case, chancre of eyelid. 

2) Case, chancre of conjunctiva in a nursling, from adult, kissing. 

Despres, A. Paris. Lourcine and Hop. Cochin. 
(See cases reported by CoCHEZ and Guignard 7 ). 



278 SYPHILIS INSONTIUM 



Deubel. 

Gaz. med. de Paris, 1881, III., p. 628 (Annales de Derm, et de Syph., 2d 
series, Vol. III., 1882, p. 129). 
Man 49 years old infected by skin grafts from own son (see Fereol). 
Devaux, J. Paris. 

Translation with notes of Musitanus (q. v.) Paris, 1710. 

1) Two cases, chancre of fingers, in midwives. 

" Art de fair e les rapports en chirurg." Paris. (Girtanner gives date 
1727; Plouquet, 1743). 

2) Case, or cases of lactation-syphilis. (Plouquet). 
Devergie, A. Paris. Hop. St. Louis. 

Bull, de l'Acad. imper. de med. Paris, 1862. Vol. XXVIII, p. 664. 

Case, vaccino-syphilis, in young man, 1 5 years old. 
De la. Syph. Vacc, Acad, imper. de med. Paris, 1865, p. 136. 
Discussion on vaccinal syphilis. 
De Vincentiis. Palermo. Univ. Prof, of Ophthalmology. 

(Profeta q. v. " Trattato prat. d. mal. ven." 1888, p. 425). 
Case, chancre of the eyelid. 
Dibon, R. Paris. 1759. 

"Effet singul. du mal. ven. sur toute un famille." Journ. de med., chir., 
pharm., etc. Paris, 1759, X., p. 415 (Girtanner, No. 508). 
Case of lactation syphilis starting a family epidemic. 
Dickinson, W. London. St. George's Hospital. 
Med. Times and Gaz., 1874, I, p. 476. 
Case, chancre of upper lip. 
Diday, P. Lyons. Hospice de l'Antiquaille. 

Traite de la syph. des nouveau-nes, Paris, 1854. (Edit. Wood's Library, 
1883). 

1) Two cases (personal), chancre of nipple (pp. 150, 185). 

2) 25 cases, Bardinet 3; Baumes i; Bertherand i; Bouchut 2; Caze- 
nave 1; Cullerier 4; Doyon and Dron i; Lallemand i; Loret i; 
Pare, A. 4; Petrini 4; Price i ; Sperino i. 

" Etude sur la chancre de l'amygdale." Mem. de la Soc. de Scien. med. 
de Lyon, 1861-2, t. I., (p. 45). 

3) Five cases, chancre of tonsil. 

"Reinfection Syphilis." Archiv. gen. de med., 1863. 

4) Statistics of 60 primary lesions (in 30 cases re-infection), there is 
mention of 4 extra-genital chancres. 

5) Case, personal, chancre of the lip (p. 33). 

6) Case, chancre of lower lip (Gorcelet), (p. 40). 

7) Case, chancre of lip (Bodet), (p. 41). 

8) Case, chancre of lip, re-infection in above case (Bodet), (p. 41). 
Gaz. med. de Lyon, Aug., 1866. 

9) Case, chancre by Eustachian infection. 
Gaz med. de Lyon, 1867. 

10) Case, chancre from glass-blowing (Gamet). 

" Histoire naturelle de la Syph., Annal. de Derm, et de Syph., 1882, pp. 
521, 637. 

11) Statistics, 90 cases of recent syphilis; of these 5 extra-genital. 

12) Four cases, chancre of lip, 3 of them in glass-blowers (pp. 52S, 640, 
641). 

13) Case, chancre of tonsil (p. 527). 

Diemer, L. Aachen. 

"Abhandlung iiber die Heilwirkung der Aachener Scbwefelthermen." 
Aachen, 1862, p. 1. 

1) Statistics of 257 syphilitics treated by D. at Aachen, 1S54-1S62, nine 
(about 3 per cent.) were infected innocently. 

2) Two cases, inoculated through surgical operations. 






ANALYTICAL BIBLIOGRAPHY 279 

3) Two cases, children, infected by nurses and attendants. 

4) Case, attendant, infected by his syphilitic patient. 

5) Case, infected through use of a tobacco-pipe. 

6) Case, infected on shipboard, through messing outfit, probably knife 
(p. 2). 

7) Two cases, mode of infection unknown. 
Dieterich, G. L. 

Die Krankheits Familie Syphilis. Landshut, 1842, vol. 1, p. 1S8. 
Case, chancre of lip, child 2 years, from kisses of mother. 
Dietlen, H. Erlangen. 

" Casuistische Beitrage fur Syphilidologie des Auges." Inaug-Dissert., 
Erlangen, 1876. 
Case, of Michel's, chancre of conjunctiva, lower cul-de-sac, in medical 
man, from auto-infection with fingers, (p. 4). 
Dimey, J. 

"Etude sur les chan. syph. du sein." These de Paris, 1891 (Annales de 
Derm, et de Syph., 1891, p. 895). 
Among 139 extra-genital chancres, in Paris cliniques, in 4 years, there 
were 18 of the breast (5 in men). 
Dixon, T. London. 

Med. Times and Gaz., May 9, 1861. 
Case, chancre of eyelid. 
Dixwell, J. Boston. 

Boston Med. and Surg. Journ., 1881, CV., p. 482. 

Case, infection per os, possibly from a drinking vessel. 
Dolbeau. Paris, Hop. Lourcine, Surgeon. 
Bullet, de therapeutique, LXXIL, 1867. 
Case, chancre of lip, in a man of 60. 
Donaldson, F. Baltimore. 

Phila. Med. News, 1885, XL VII., I., p. 173. 
Case, chancre of tonsil. 
Dohng. 

"Mothers and Infants, Nurses and Nursing," Boston, 1859, p. 104 (N. Y. 
Med. Record, Vol. XXX., 1886, p. 511). 
Case, infection of child from wet-nurse. 
Dor, H. Lyons. 

(Personal communication from De Beck to author of this book; source 
unknown. 
Nine cases of chancre of the eyelid, seen between 1S68-1883. 
Dornig, G. Laibach. , 

Wiener med. Wochenschr. , 1885, XXXV., p. 330. 

Case, chancre of right lower eyelid in a laundress ; etiology not given, 
but most likely from soiled clothing. 
Doutrelepont, H. Bonn. Univ. Professor of Dermatology and Syphilis. 

Eighteen cases of extra-genital chancre, given by von Broich, q. v. 
Dowse, T. S. London. 

Lancet, 1S77. I., p. 482. 
Case, chancre of forearm in a girl nine years old, from holding a syphil- 
itic infant. 

Doyon, A. (See Dron). 

Draper, W. H. New York. 

Archives of Dermatology. New York, Vol. II., p. 230. 

Case chancre of the lip, from kissing, wife infected by husband. 

Dron, Achille. Lyons. Hosp. de l'Antiquaille (female service). 

(Doyon, A. and Dron, A.) Gaz. hebdom. de med., Paris, 1854, Nos. 30, 31. 



280 SYPHILIS INSONTIUM 



(Tardieu, "Etude med- legal, etc.," Paris, 1879, p. 226-229). 

1) Six cases, nurses infected by nurslings. 

(Doyon, A. and Dron, A.). Rev. therap. du Midi, Montpellier, 1859, 
XIII, pp. 373, 401. 

2) Cases of transmission of syphilis from nursling to nurse. 
Annales de Derm, et de Syph. 1870, p. 161. 

3) Twelve cases, nurses infected by nurslings. 

4) Five cases, nurses become infected, and also infect other nurslings. 
Lyon medicale, 1870, p. 512. 

5) Statistics ; 106 nurses, infected by nurslings, transferred from Charite 
to l'Antiquaille, 1860-1870. 

6) Extensive family epidemic of syphilis. 
Lyon medicale, 1877, Nos. 26, 28, 30, etc. 

7) Statistics of chancre of the lip, 18 70-1 875, chiefly in glass-blowers: 8 to 

10 cases yearly. 
Cited by Rollet, " Traite des mal. ven." Paris, 1866 (p. 617). 

8) Case, woman, aged 70 years, infected, lips and tonsils from the care 
of her grand-child. 

(Dron's cases have been freely referred to by others, see Audoynaud, 
Diday, Fournier, Rollet, Roussel, Viennois). 
Drysdale, C. R. London. 

British Med. Journ,, Apr. 25, 1S68, (with R. W. Dunn). 

1) Case, vaccino- syphilis. 
Lancet, 1869, II, p. 639. 

2) Case, chancre of lower lip, girl, aged 19, from bite of a young 
syphilitic child; patient then infects her sister, girl, aged 13, chancre 
of vulva from sleeping with her. 

Lancet, 1870, I, p. 482. 

3) Case, chancre (?) in throat, from nursing bottle. 

4) Case, chancre of nipple, from same child. 

5) Case, infection (?) of child of case 4. 
British Med. Journ., Nov. 16, 1872. 

6) Case, infection from cigar stump. 
"Syphilis, its nature and treatment" London, 1872. 

7) Two cases, chancre of lip, from kissing. 

8) Three cases, nurses infected by nurslings. 

Dubois, P. Paris. 

Bouchut. Traite prat, des mal. des nouv.-nes, 1st edit, p. 878. 
Case, chancre of lip, in pregnant woman. 

Dubois, Havenith. Brussels. 

Presse Med. Beige., 1890, XLII, 9, p. 129. 
Two cases, chancre of lower lip, in a woman 60 years old and her 
daughter. 

Dubreuil, A. Montpellier. 

Gaz. hebdom. de Montp., 1888, No. 9, p. 100. (Annales de Derm, et de 
Syph., Vol. IX., 1888, p. 597). 

Case, chancre external angle of right eyelid. 
Dubreuiih, W. Paris. Hop. St. Louis, service of Fournier. (Interne). 

Case, chancre of chin from razor cut (see Zwetitcii). 
Dubreuiih, W. Bordeaux. 

Case, multiple chancre of face, (see Braquehaye). 
Dufour, C. Paris. Hop. du Midi. (Interne). 

Two cases, chancre of fauces, (Fournier " chancre cephalique," 1858). 

Duguet. 

Case, chancre of tonsil, see Le Gendre 8 . 

Diihrsen. 

Pfaffs Mittheilungen aus dem Gebiete der Med. Chir. u. Pharm., Bd. L, 



ANAL YTICA L BIBLIO GRA PH Y 



Hef. 3, 1832 * (quoted by Boeck Traite, d. 1. Radesyge, etc., i860, p. 47). 
Treats of the Morbus Dithmarensis. 
Dulac,,P. Paris. Hop. St. Louis, service of Bazin. 

" Etude sur la syphilis contracte a un age avance. ," 1878, p. 58. 
Case, chancre, septum of cares (service of Gosselin q. v.). 
Dulles, C. W. Philadelphia. 

1) Cases of syphilis from tattooing (see Epidemics, and Maury and Dulles). 
Phila. Med. and Surg. Reporter, Jan. 5, 187S, XXXVIII., p. 4 (Amer. 

Journ. of Med. Sciences, 1878, p. 62). 

2) Case, chancre of lip, received from a dentist. 
Archives of Dermatology, New York, VII, 1881, 144. 

3) Case, chancre of eyelid. 

Dunn, R. W. London. Farrington Dispensary. 
Brit. Med. Journ., 1S65, II., p. 600. 

1) Fifty-three cases of vaccination syphilis. 

Report of Army and Navy Commission, London, 1S67, p. 506. 

2) Case, chancre of lip, man infects sweetheart by a bite (this is un- 
doubtedly same as Drysdale's). 

Dupond, G. 

" Etude sur la syphilis du nez et des fosses nasales," These de Bordeaux, 
1887, Paris. 

1) Case, Eustachian-sound inoculation. 

2) Case, chancre of fauces (both in service of Moure), pp. 22, 32. 
Du Pont. 

On the contagiousness of secondary forms of syphilis, and on chancre of 
the head. Presse med. Beige, Bruxelles, 1859, No. 26, 32*. 

Dupre, Achille. 

These de Paris, 1857. 

Case, chancre of the eyelid, from kissing (p. 11). 

Dupuytren. Paris. Hotel Dieu, Senior Surgeon. 

Case, double chancre of breast and eyelid, in a nurse from a nursling 
(reported by Rognetta, q. v.). 

Durante. Capistrello. Dispensary Physician. 

(Notes of the progress of the endemo-epidemic in Capistrello. See Tan- 
turri, Demarchi, and Epidemics). 

During, E. von. 

Monatsh. fur prakt. Derm., XIII, 1891, p. 471. 

1) Seven cases, chancre of lip and cheek. 

2) Three cases, chancre of tonsil. 

3) Case, chancre of right breast. 

4) 31 cases in neighborhood of anus from pederasty. 

Durkee, S. Boston, U. S. A. 

Boston Med. and Surg. Journ., LIX., 1859, p. 460. 

1) Two cases, nurses from same nursling (same as reported by Bennett 
q. v.). 

"Treatise on Gonorrhoea and Syphilis," Phila., 1864, p. 278. 

2) Case, wet-nurse infected by moribund nursling, at nipple (Massa- 
chusetts Gen. Hosp , Mar., [853, service of Bigelow). 

3) A mother and young daughter drew the breasts of this patient, and 
each received, beyond all question, chancre of the throat. 

Dfisterdorf. Willebadessen. District Physician. 
Hufeland's Journal, 1826, LXII, I., p. 114. 
Epidemic from lactation (sec Epidemics). 

Dutschinski, A. A. Staro. Konstantinov. 

Vratsch, June, 1889, p. 167 (Brit. Med. Journ., 1869, p. 427). 



282 SYPHILIS INSONTIUM 



Epidemic from midwifery inoculation ; 36 infected (13 male, 23 female) 
in total population of 316. (See Epidemics). 
Dzondi, K. H. Halle. Prof, of Medicine. 

" Neue zuverlassige Heilart der Lustseuche " Halle, 1826. 
Case, chancre of the groin, in a woman 80 years old, infection through 
an undergarment (p. 5). 
Ebrard, E. Paris. 

"Neuroses syphilitiques." Gaz. med de Paris, 1843, Feb. 25, p. 120. 
(Lagneau, fils "Mai. syph. du syst. nerv." Obs. 123). 
Case, woman infected by nursling ; cerebral syphilis. 
Edes, R. T. Boston. Prof. Therapeutics, Harvard University. 
Boston Med. and Surg. Journal, 1881, CV., p. 250. 

Case, chancre of eyelid, from application of tongue to eye. 
Edlefsen. Keil. Prof, in Chiei of the Medical Pohklinik. 

"Casuis. Beitr. zur Frage von Con tag. der hered. Syph., Berlin, klin. 
Wochenschr. 1876, No. 5, p. 60. 
Case, grand-mother acquired syphilis from infant which she tended; site 
and mode unknown. 
Egan, J. C. Dublin. Surgeon, Westmoreland Lock Hospital. 

Dublin Quarterly Journ., May, 1846; London Lancet, Aug. 22, 1846. 
Cases of extra-genital infection, afterward embodied in "Syphilitic 
Diseases," etc., London, 1853, p. 296. 

1) Case, chancre of left breast, from nursing syphilitic infant. 

2) Case, chancre, both breasts, from nursing syphilitic infant. 

3) Case, chancre on neck, site of pin scratch, inoculated from mouth of 
syphilitic infant, (p, 302). 

4) Case, infection, probably on tongue, from kissing syphilitic infant in 
the mouth, and about nates, (p. 304). 

Eichman. 

Schmidt's Jahrbucher, LXXXIII., p. 184. 

Case, woman infected by kissing an infant relative. 
Elliot, G. T. New York. Skin and Cancer Hospital, Ass't Physician. 
Journ. of Cutan : and Genito-urinary Diseases, 1888, p. 334. 
Case, faucial chancre in a young girl, from lover. 
Elliotson, J. London. 

"On secondary syphilitic transmission," Med. Times and Gaz., London, 
Sept. 4, 1858. 
Case, possible transmission by a comb; first symptoms being a localized 
syphilide of scalp (such cases have occurred). 
Ellis, E. London. Victoria Hospital for Sick Children, Physician. 

"Pract. Man. of the Diseases of Children," New York, 1879 (3d ed., in 
Wood's Library for 1879). 
Case, nurse infected by nursling. 
Eltzina, Z. J. 

Vratsch, 1882, Nos. 50-51. 

1) Statistics from rural districts of Russia: of 55 syphilitic peasants, 
observed in the Krapivna district, 45 were infected extra-genitally ; 
43 through family life; and 2 through suckling (most of the cases 
were in children) only two by coitus. 

Vratsch, 1S89, p. 155 (Brit. Journ." of Dermatol., 1889, p. 424). 

2) Case, chancre, left little finger, girl aged 13 months; parents and 
family healthy; infected by caress of stranger. 

Emser, H. Ulm. Chaplain to George of Saxony, 1504. 

" Miracula St. Bennonis. . . Acta sanctorum," Rome, 1521, (Fuch's " Die 
Aelteste Schrifts. u. Leusts." Gottingen, 1843, p. 330). 
Account of numbers with Morbus Gatiecus, miraculously cured by St. 
Benno ; among these, many from the same family, and many children. 



ANALYTICAL BIBLIOGRAPHY 283 

Engelsted, S. Copenhagen. Kommunspital. 
" Veneriske Sygdome." Copenhagen, 1876. 

1) Three cases, chancre of finger, in midwives (p. 34). 

2) Case, chancre of lip from a cigar stump (p. 33). 

3) Case, a two-year-old child, with acquired syphilis, and cerebral soft- 
ening (p. 239, case 37). 

4) Case, an adult heredito-syphilitic, had a hospital record of infecting 
his wet-nurse in infancy (p. 326). 

5) Case, similar, with addition of nurse infecting own child (p. 305). 

6) Statistical ; children with acquired syphilis in Comm. Hosp. (p. 324). 
Erichsen, J. E. London. Westminster Hospital. Surgeon to the Queen. 

Report of Army and Navy Commission, etc., London, 1867. 

1) Case, infection from kissing, probable chancre of tongue (p. 430). 

2) Case, similar to above, infection per os, kissing (p. 430). 
Escherich. 

" Zur Untersuchung gegen Dr. Hiibner in Hollfeld wegen fahrlassiger 
Korperverletzung durch Impfang " Arztliches Intelligenzblatt 1S54, 
No. 25, p. 198. 
Hiibner inoculated directly 8 children, and 9 indirectly, with syphilis by 
vaccination (see Hubner). 

Esof. 

Vierteljahr. f. Derm. u. Syph., 1889, XXL, p. 253. 

Case, chancre of eyelid in a woman, from the entrance of amniotic fluid. 
Estlander, J. Helsingfors. Eye-clinic. 

Klin. Monatsblatt. Zehender's, 1870, 259. (Hock, q. v.). 
Family epidemic, discovered through a gumma of conjunctiva in one 
member, ten years later. 
Eulenberg. Berlin. 

" Uebertragung der Syph. durch Vaccination." Berliner klin. Wochenschr., 
1872, No. 38 (p. 461). 

1) Case of vaccino-syphilis, 7 months after vaccination. (See Epidemics). 
Handb. des offentlichen Gesundheitswesens, Bd. I, Berlin, 1SS1. (Article: 

Beschneidung) Archiv f. Derm. u. Syph., 1883 (p. 289). 

2) Circumcision syphilis. 

Tageblatt der Naturforscherversammlung zu Leipzig (Archiv f. Derm. u. 
Syph., 1883, p. 543)- 

3) Vaccination syphilis. 

Eustachius, Rudius. Padua, Univ. Prof, of Medicine. 

'' De morbo gallico libri v." Venetiis, 1604. (Edited by Mundinus). 
(Girtanner., "Bibliogr." and Simon " Die Leustseuche," etc.). 

1) Case, nurse infects two nurslings (probably the converse was the case). 
Lib. I., cp. VIII). 

2) Case, chancre of tongue from kissing. 
Everardus, A. Middelbourg, Seeland. 

" Die Neu-erweckte Sauger-seuehc in ihrer Vergleichung mit der Frant- 
zosen oder Indianiscnen Krankheit, etc.," (from the Latin edition of 
the author : bound with Blancaard, and other Dutch and English 
authors, Leipzig, 1689). (See also Rosen von Rosenstein " Kinder- 
krankheiten "Gottingen, 1798, p. 728). 
Epidemic, afterwards endemic, in Seeland, 1654, which began from 
breast-drawing. (See Epidemics). 
Evmenieff, V. A. 

A report of syphilis in the Ostrogoshsk Voronej Govern., 1 885-1 886 (Med. 
Beseda, 1S88, p. 7-10). 
Statement: Among 2653 cases of syphilis observed among the peasants, 
1246 or 46.9 per cent, were affected through domestic propagation, 
80 by inheritance, 390 by coitus, and in 937 eases, the mode was 
undetermined. Extra-genital syphilis is especially spread by children, 



284 SYPHILIS INSONTIUM 



with play-things, common meats, breads, sweets, etc. — infection 
through the mouth is most frequent. 

Ewertzen. Fredricksborg. District and Batallions Physician. 

Froriep's Notizen, Weimar, 1832, No. 745, from Danish Bibliothek f. Lager. 
Epidemic of vaccino-syphilis, Fredricksborg, 1830. (See Epidemics). 

Fabre, P. Paris. 

"Traite des malad. vener." Paris, 1775. 

Case, probably faucial chancre, conjugal, in wife (p. 9). 
" De la syph. chez les femmes enceintes chezles nour. et chez les enfans." 
Bibliotheque de med. prat. Paris, 1848, VIII. (p. 610-654). (Proksch, 
"Die Litteratur iiber die Vener-Krankh. Bonn. 1891, 3te Bd. p. 26). 

Fabricius de Hilden. 

Obs. chir. et med., 1716, centur. i, obs. c. (Lancereaux — "A treatise on 
Syphilis, etc." New Sydenham Soc. London, 1869, Vol. II., p. 246). 
Case, infection of girl of 15 years from wearing the drawers of a male 
friend in a carnival. 

Facen, J. Milan. 

Gaz. med., Lombard., Mai, 1849 (Gaz. med. de Paris, 1849). 

1) Small lactation epidemic. 

2) An account of " Facaldina," (No. 21, p. 183). (Quoted by Lancereaux 
Treatise on Syph., etc., 1868, p. 41)*. 

Faguer. 

Four cases, chancre of the tonsil in one family. (See Rollet 8 ). 

Falcone, T. Naples. 

" Contrib. di patologia e clmica Dermatosifilopatica." Giorn. ital. di mal. 
vener. etc., Milano, 1887, XXVIII., No. 3. 
Case, chancre, inner canthus right eye, from use of an opera-glass 
(p. 142). 

Fallopius, G. Padua and Pisa. Prof, of Anatomy. 

"Tract, de morbo Gallico." Edited by Peter Angelus, Patavia, 1564. 
(Girtanner, 151). 
Case, chancre of buttocks in an old man from the privy-seat of a house 
where several syphilitics were lodging. 

Fano. Paris. Hop. du Midi. (Interne). 
Fournier "Chancre cephalique." 1858. 

1) Two cases, chancre of the lip. 

Jour, d'oculistique et de chir., Mar. 25, 1874, (cited by Touchaleaume, q. 
v., p. 14). 

2) Case, chancre, bulbar conjunctiva. 

Farlow. Boston. 

Boston Soc. for Medical Improvement, Nov. 2S, 1S92. Boston Med. and 
. Surg. Journ., Jan. 5, 1893. 
Case, chancre, upper lip, man, mode of infection not stated. 

Farre, A. London. 

Report of Army and Navy Commission, etc., 1867 

Cases, no documents, of nurses infected by nurslings, p. 472. 

Farriols, A. Barcelona. 

Gaceta san.de Barcelona, 1SS8-9, I., p. 152 (known only by title "Chancro 
sifilitico en la mejella derecha"). 
Case, chancre of right cheek. 

Faught, G. G. Philadelphia. 

New York Medical Record, 1S91, XL., p. 511. 

Case, chancre of the gum, in a woman 19 years old, from kissing a man 
with syphilitic mouth lesions. 



ANALYTICAL BIBLLOGRAPHY 285 



Favier. Lyons. 

Rollet "Traite d. mal. ven." 1865, p. 617. 
Case, chancre of tonsil. 

Fedchenko, N. P. 

"Three cases of chancre after shaving," Medezinskoje Obozrenie, 1S90. 
No. 1, p. 19, (Vratsch, 1891, No. 44, p. 989). 

1) Case, chancre on the neck, below the left lower jaw. 

2) Case, chancre on the chin, in a student, after cutting a comedo with 
a razor recently bought. 

3) Case, chancre on the angle of the lower right jaw. 
Fedotow, A. A. See Kedotoff. 

Feibes, E. Aix-la-Chapelle. 

Berliner klin. Wochenschr., 1889, No. 23, p. 519. 

Case, chancre of the cheek, in a man 25 years old, after shaving by 
barber. 
Fenwick, G. Montreal. 

Canada Med. and Surg. Journ., Aug., 1875 (Reported by Cline). 

Case, chancre of eyelid, source unknown, unless from towel used by 
room-mate. 
Fereol. 

Progres med., 1SS1, No. 46, p. 916. (Annales de Derm, et de Syph. 1882, 
p. 129). 
Case, syphilis, communicated by epidermic. grafts (Deubel's case, q. v.). 

Fernandez, J. S. 

"Observacion clinica di un chancro indurado del parpado superior del 
lado izquierdo recogida en la sala de Sante Tomas del doctor Lailler" — 
Anfiteatro anatom. Madrid, 1875, III., p. 433.* 
Case, chancre, upper eyelid. 

Fernelius, J. Paris. Physician to the King of France. 

"De abditis rerum causis, lib. II., 1548, II., cp. XIII. (also Girtanner 152). 

1) Nurses infected on the breast by syphilitic nurslings. 

2) Infection on the lip, by kissing. 

3) Midwives, inoculated on the finger, by professional exposure. 

Feulard, H. Paris, Hop. St. Louis, Chef de clinique. 
Annales de Derm, et de Syph, 1890, p. 320. 

1) Statistics of extra-genital chancres at clinic in 1889: 34 in all (exclud- 
ing multiples); lips 19, tongue 3, tonsil 1, chin 1, breast 3, finger 3, 
arm (vaccination) 2, anus (infant) 1, abdomen and inguinal 1. 

Annales de Derm, et de Syph., 1891, p. 220 (Soc. de Derm, et de Syph.). 

2) Case, chancres on both arms, acquired in hospital, during treatment 
for scabies (see Fournier). 

Annales de Derm, et de Syph., Vol, III., 1892, No. 7, p. S05. 

3) Statistics from Fournier's clinic, Feb. 1, to Nov. 1, 1891: 75 cases 
extra-genital chancre, 48 men, 24 women, 3 infants; S6 chancres 
altogether presented, of these 68 were cephalic as follows: upper lip, 
25, lower lip, 14, labial commissure, 7, tongue, 4, tonsils, 6, cheek, 2, 
chin, 10, the remaining 18 as follows: breast, 5, anus, 4, umbilicus, 1, 
forearm, 3, fingers, 4, thigh, 1. 

Trans. Soc. de derm, et de syph., Seance, Nov. 10, 1892 (Annales de 
Derm, et de Syph., Vol. III., 1892, No. 11, p. 1156). 

4) Case, chancre, left cheek, in male infant of 2 years ; infection probably 
from neighbor in whose care the child was left (service of Granciikr). 

5) Case, chancre lower lip, near left angle of mouth in little girl of y/z 
years, from syphilitic mother. 

6) Case, chancre, left cheek, near outer part lower eyelid, in boy of 4 
years, infection from maternal uncle. 

7) Statement: the last three cases were observed in a period of less than 



286 SYPHILIS INSONTIUM 



4 months, among n cases of infantile syphilis observed in the clinic 
since Dec. 1891. 
Fieuzal, J. Paris. 

Bullet, de la clin. nationale ophthalmol. des Quinze-Vingts, T. I., Paris, 
1883. 
Case, chancre of eyelid, source unknown (p. 158). 
Finger, E. Vienna. (Prof. Zeissl's and Prof. Neumann's Clinics). 

" Ueber ein const, nerv. storung, etc.," Viertelj. f. Derm. u. Syph,, 1881, 

P- 273. . 

1) Case, chancre of upper lip, left side. 

Aerztl. Bericht. d. k. k. Allg. Krankenh., Wien (1882), 1883, p. 132. 

2) Frequency and seat of syphilitic primary lesions. 

" Die Syphilis u. d. venerische Krankheiten, Wien, 1886. 

3) Case, chancre of lip, from cigar stump, p. 14. 

4) Four cases of infection from bites ; chancre of nose, ear, thumb, toe. 
Fischer, H. Breslau. Univ. Prof, of Surgery. 

Case of circumcision syphilis, (See Jaffe). 
Fisher, C. I. Supt. State Alms House, Tewksbury, Mass. 

" Necessity of social and statute recognition of syphilis." Boston Med. 
and Surg. Journ., July 31, 1890. 
Case, chancre of lip, in female domestic, cause not stated. 

Fitz. U. S. Military Service. 

Case, chancre of lip, in a soldier from a comrade, through drinking from 
the orifice of a faucet. (See Arthur). 

Fitzgerald, T. A. Dublin. Dublin Eye Infirmary. 

(De Beck q. v. personal communication, from Dr. F.). 

Two cases, chancre of eyelid, personal, and one not elsewhere mentioned, 
seen 1868, at Lailler's Clinic, Hop. St. Louis. 

Fitzgibbon, H. Dublin. President Royal Coll. Surg. , Ireland. 

Pres. address, "Syphilis," Dublin, 1888 (Edinb. Med. Journ., 1889, 
XXXIV., p. 854. Also London Med. Rec., 1889, No. 15). 

1) Case, chancre of lower lip, banker, counting roll of bank bills, stolen 
by a prostitute and hid in her vagina. 

2) Case, chancre of right thigh, in a girl of 14, in the site of chafe from 
riding saddle, from exposure to seat of a railway water closet. 

Flamande. 

Journ. complem. d. Diet. d. sci. med., V., p. 135. 

Domestic epidemic at Chavanne-Lure, 1828. (See Epidemics). 

Fleischer, A. Kiew. Prof, in the University. 

Proceed. Soc. of Physicians of Kiew, 1885-86, p. 73, (London Lancet, 
1886, Vol. II., p. 988). 
Two cases, chancre of chin, in site of razor cut. 

Fonseca, L. da. Lisbon. 

" Cancro prim, syphilitico da palpebra," Archiv. ophthalmo-ther. de 
Lisboa, 1881, II., p. 60. 
Case, cnancre of eyelid, source unknown. 

Fontanus, N. Amsterdam. Prof, of Anatomy. 

" Respons. et curat, medic", 1637 (Girtanner No. 386). 
Case of syphilitic infection by mere contact. 

Foot, Jesse. 

"Important researches upon the existence, nature, and communication of 
venereal infection in pregnant women, new-born infants and nurses, 
by the late P. A. O. Mahon. These are contrasted with the new 
opinions of the late John Hunter upon this subject, together with 
observations thereon." London, 1808, 8°, pp. IV, 5-1 10*. 



ANALYTICAL BIBLIOGRAPHY 287 



Ford, W. H. 

St. Louis Med. and Surg. Journ., 1881, XL., p. 158. 

Case, chancre on shoulder of nurse, from syphilitic child. 
Forestus, P. Leydem Univ. Prof, of Medicine. 

"Observ. et cur. med. et chirurg., libri XXXII. ," Lugduni-Batavorum, 
1591-1606 (Girtanner No. 146) (Rosex vox Rosexsteix "Kinderk." 
Gottingen, 1798, p. 728). 
Case, triple infection, of nature of family epidemic ; nurse from nursling, 
infecting her own two children. 

Fortin. Paris. 

"Transmission de la syphilis d'un nourrisson a un nourrice." L'Union 
medicale, 1866, 135, 136. 
Case, syphilis communicated from a nursling to nurse. 
Fortuniades. 

" Etude sur le chan. syph. des paupieres." These de Paris, 1890 (Annales 
de Derm, et de Syph., 1890, p. 83S). 
Review of subject ; making chancre of eyelids, 3 per cent, of extra-genital 
chancres. 

Foster, F. P. New York. Chief of Vaccine Department, N. Y. Dispensary. 
Amer. Journ. of Syph. and Dermat., Vol. I., 1S70, pp. 189, 293; Vol. II., 
1871, p. 40. 

1) An able review of the reported cases of vaccinal-syphilis to date. 

2) Case, chancre of tonsil (reported by Fox, G. H., 6 q. v.). 

Foucart, A. 

Gaz. des Hop., Paris, 1844, No. 11, p. 41. 

Case, chancre of nipple, from syphilitic nursling. 

Fournie, E. Paris. Institution for Deaf and Dumb. 
L'Union med., 1863, XVIII., p. 583. 

Case, chancre of pharynx, Eustachian infection, first case on record. 

Fournier, A. Paris. Hop. Lourcine and St. Louis. 

L'Union med., 1858, and " Lecons sur la chancre," Paris, 1858-60. 
Appendix. 

1) 19 cases, extra-genital chancre, personal, (service of Ricord), (p. 247- 
250). 

2) 58 cases, extra-genital chancre (Puche, 28, p. 246; Caby, 7, p. 250; 
and others, 23). 

" De la contagion syphilitique." Paris, i860. 

3) Case, chancre of upper lip, man 23 years old (p. 54). 

4) Case, chancre of lower lip, man 21 years old (p. 56). 
Archiv. gen. de med., Paris, 1863, Ser. VI., Vol. II., p. 237. 

5) Case, chancre of tonsil, Eustachian tube inoculation. 

11 Soc. med. des Hop.," L'Union med., 1864, XXIV., p. 264; also, ibid., No. 
129, p. 216. 

6) Two cases, chancre from Eustachian tube inoculation. 
Dictionnaire de med. et de chirurg. prat., 1867, VII., p. 75, 

7) Statistics, of two hundred cases of cephalic chancre. 
(Reported 1869, by Audoynaud, q. v. These de Paris). 

8) Two cases, chancre of nipple, nurses from nurslings. 

"Legons sur la syph. etud. plus partic. chez la femme." Paris, 1S73 (Clinic 
of the Lourcine). 

9) Three cases, chancre from using syringe and infected instruments 

(P. 55). 

10) Case, chancre in female child, Eustachian tube inoculation (p. 55). 

11) Case, chancre of lip (p. 56). 

12) Case, chancre of the finger in a girl (p. 52). 
(Reported, 1875, by Appay, q. v.). 

13) Case, chancre of right nipple, nurse from nursling (p. 98). 



SYPHILIS INSONTIUM 



14) Case, chancre of left nipple, female, aged 18 years, from kiss by lover 
(pp. 60, 102). 

(Reported 1876, by Saw, q. v. These de Paris). 

15) Case, chancre of eyelid, in physician, from saliva (p. 63). 
Annales de Derm, et de Syph., Vol. VIII. , 1876. 

16) Case, chancre of neck, in man 22 years old, from a bite (p. 64). 

1 7) Case, chancre of neck, in a female (p. 66). 
Gaz. des Hop., Paris, 1877, P- 1109. 

18) Case, chancre of both nipples, nurse from nursling, patient 27 years 
old. 

19) Case, 23 chancres of both nipples, (16 on right, 7 on left,) patient 26 
years old. 

(Reported by A. Sturge, q. v.) Med. Times and Gaz., London, 1877, II., 
p. 116. 

20) Case, chancre of right nipple, from nursling; A. M. , female, 32 
years old. 

21) Case, chancre of left nipple, from nursling; E. C. B. , female, 34 
years old. 

22) Case, chancre of left nipple, from nursling; A. B., 28 years old. 

23) Case, chancre of tongue, child from its nurse. 
(Reported, 1878, by A. Pontet, q. v. These de Paris). 

24) Case, chancre of vulva, child seven weeks old, from a sponge (p. 10). 

25) Case, chancre in a child, 18 months old., from its nurse (p. 15). 
" Nourrices et Nourrissons Syphilitiques," Paris, 1878. 

26) Case, nurse infected by nursling (p. 9). 

27) Case, syphilis in husband of above nurse (p. 9). 

28) Case of Delore (p. 9) ; four cases of Dron (pp. 66-67) ; six cases before 
tribunals, nurses from nurslings. 

(Reported by HuLOTq. v.) Annales de Derm, etde Syph., Vol. X., 1879^.29. 

29) Eighteen cases, from service of Fournier. 
" Syphilis et mariage." Paris, 1880. 

30) Case, nursling, infected by nurse, infecting its mother, grand- 
mother, and two nursery maids (p. 211). 

31) Case of Hillairet (p. 211), infant infects both grand parents by 
nursing bottle. 

32) Nine cases, extra-genital chancre; lip 4, finger 2, nose 1, Eustachian 
tube 1, breast 1 (pp. 231-264). 

(Reported, 1880, by Jumon, q. v. These de Paris). 

33) Four cases, extra-genital chancre. 

(Reported, 1882, by Guignard, q. v. These de Paris, pp. 24, 53). 

34) Cases, chancre of nose and one of tonsil. 
Semainemed., Paris, 1882, II., p. 125. 

35) Seven cases; tongue 1, forearm 1, and five with site not mentioned. 
(Reported by Lavergne, q. v.) Annales de Derm, et de Syph., 1884, pp. 

332, 380. 

36) Statistics; 27 extra-genital cases. 

(Reported, 1884, by Zwetitch, q. v. These de Paris). 

37) Four cases, chancre of chin, presumably from shaving. 
(Reported, 1885, by Lesage q. v. These de Paris). 

38) Two cases, chancre from tooth wounds. 

" Logons sur la periode preataxique du tabes d'orig. syph.'' Paris, 1885. 

39) Case, chancre of chin (p. 331, Obs. 85). 

40) Case, chancre of right little finger, man of 43 years (pp. 228, 414). 
(See Bo u illy). 

41) Case, chancre of throat (p. 332, Obs. 8S). 

42) Case, chancre of lip, man 21 years old (p. 353, note V). 
Annales de Derm, et de Syph. Paris, 1886, p. 87. 

43) Case, chancre in furrow behind ear in woman of 24 from husband. 

(Case of Hermet). 
Semaine med., 1886, No. 49. , 



ANALYTICAL BIBLIOGRAPHY 289 



44) Two cases, infection, nurse from nursling, one infected her own child. 
<c La Syphilis hereditaire tardive," Paris, 1886. 

45) Case, infection in a girl, by Eustachian catheter, (p. 590). 

46) Statistics, of own private practice, family infection : sources of infec- 
tion in 42 cases; 19 from parents, 8 from nurses, 4 from attendants, 
etc., 2 from children, 2 from vaccination, 1 from medical contagion, 
4 from criminal attempt, 2 unknown (p. 594). 

47) Case, infection of a child by its mother (p. 606). 

48) Case, infection, nurse from nursling ; infecting her own daughter (pp. 
607, 632). 

49) Case, chancre of lower lip, nursling from nurse (p. 610). 

50) Cases, chancres; mouth 5, cheek 4, neck 4, abdomen 1, perineum 1 

(P- 599)- 
Semaine medicale, 1887 (Le Practicien, Oct, 31, 1887). 

51) Statistics of 27 }?-ears private practice; 8 infection from nursing, 5 
midwife, 12 domestic, 4 syph.-acq., 2 vaccination, 2 Eustachian tube, 
4 unknown. 

Gaz. hebdom. de med. et de chir., Paris, 1887, No. 45, (pp. 726-727). 

52) Case, infection, nursling by nurse, infecting 

53) Case, chancre lower lip, mother, infecting her husband by coitus. 

54) Case, chancre of mouth, in grand-mother 60 years old. 

55) Two cases, chancre of mouth in sisters, virgines intactae. 

Extrait de Bull, de l'Acad. de med., Seance, Oct. 25, 1887 (Annales de 
Derm, et de Syph., 1887, p, 757). 

56) Statistics; 887 cases of syphilis in women, of which 45 were non- 
venereal, 7 hereditary, 4 infected in childhood, 8 from nursing, 5 
from midwives, 12 from domestic propagation, 2 from vaccination, 2 
Eustachian catheter, 1 drinking from unclean bottle, 4 source un- 
known. 

(Reported, 1887, by Nivet q. v. These de Paris). 

57) Statistics; 47 cases of extra-genital chancre in year 1885-6, public and 
private practice; 595 cases in Fournier's entire public and private 
practice of about 30 years. 

Gaz. hebdom. de med. et de chir., 1887, No. 45 (Monat. f. prakt. Derm., 
1888, p. 1 160). 

58) Case, infection, nursling from wet-nurse, infecting five other persons. 
Reun. clin. hebdom. de l'Hop. St. Louis (Annales de Derm, et de Syph., 

Vol. X,, 1889). 

59) Case, infection, nursling from nurse infected from a nursling (p. 56S). 

60) Case, chancre of lower lip, female 29 years old (p. 806). 
"Lecons sur la syph. vaccinale." Paris, 1889. 

61) Case, infection, nursling from nurse; infecting mother, grand-mother, 
father, and two nurses (p. 26). 

62) Two cases, chancre of forearm, from vaccination (p. 72). 

63) ( Troup of five cases, from vaccination (p. 83). 

64) Group of several cases, one of them treated by Fournier (p. 89). 

65) Group of six cases, from vaccination (p. 93). 

66) Cases of Adelasio, p. 27; CERiOLi,p. 30; Cory, p. 15; Closmadeuc, p. 
52; Depai l, pp. n, 31 ; Denis, p. 32; Galligo, p. 31; Hutchinson, pp. 
90, 102; Hubner, p. 38; Jones, p. 89; Lecoq, p. 88; Lorain, p. 155; 
Millard, p. 9; Orv, p. 155; Trousseau, p. 42; Viennois, A., p. 30; 
Wegeler, p. 22. 

Reunion clin. hebdom. de l'Hop. St. Louis (Annales de Derm, et de Syph., 
Vol. X., 1889, p. 204). 

67) Case, chancre of glans and prepuce from scratching in scabies. 
Bull, de la Soc. de derm, et de syph. Seance, Apr. 12, 1S90 (Archiv L, 

Derm. u. Syph. Vol. 23, 1891, p. 789). 

68) Case, chancre of nipple, nurse from nursling. 
Annales de Derm, et de Syph., 1891, p. 405. 

69) Case, chancre of forearm, hospital infection. 

20 



290 SYPHILIS INSONTIUM 

New York Med. Journ., 1891, Vol. XII., No. 16, p. 457. (Pans Letter). 
70) Case, chancre of each forearm, from accidental contagion. 
Fox, G. H. New York. 

"Oral chancre, cases and comments," N. Y. Med. Journ. XXXI 1880, p. 
145- 

1) Case, chancre of end of tongue in a child two years old, acquired 
from a visitor with mucous patches of lips. 

2) Case, chancre of lower gum, below left incisors, father of above. 

3) Case, chancre of lower lip, eight-year-old daughter of above. 

4) Case, chancre of mouth, mother of above children. 

5) Hereditarily syphilitic child of above, died at about six months. 

6) Case of Foster's, chancre of right tonsil. 

7) Case of Bangs', chancre of gum. 

Photogr. illustr. of Cutan. Syph., New York, 1880, p. 36. 

8) Case, chancre of upper lip, from kissing. 
Fox, Tilbury and Farquhar. 

On certain endemic skin and other diseases in India, etc., 1876. 
Yaws, Delhi sore, Biskra Bouton, etc. 
Fox, T. C. London. Physician to the Skin Department, Westminster Hosp. 
Trans, of the Clinical Soc. of London, 1888, XXL, p. 2S1. 

Case, chancre of upper lip, boy 5 years old, from syphilitic baby brother. 
Fracanzianus, A. Padua. 

41 De morbo Gallico liber," Bononise, 1564. 
Case, girl, aged seven, acquired genital chancre from an adult female, 
through an undergarment. 

Francke, C. M. 

Morbus Dithmarsicus. Dissert. Inaug. Kiliae, 1838. 

Frankel, B. 

"Beobacht. d. angeblich durch Vaccinat. syph. inficirten Kinder." Medi- 
cinische Gesells. Berlin, klin. Wochenschr., 1872, IX., p. 474. 
A study of vaccino-syphilis, no new cases. 

Fredet. Clermont, France. 

Archiv. d. tocologie, 1888, No. 4: also, L'Union med. 1888, No. 99, p. 209. 

1) Case, nurse, chancre of both nipples, from syphilitic foundling. 

2) Case, nurse infected by nursling. 

Freund, M. B. Breslau, Docent at the University. 

"Zur Prophylaxe der Impfsyphilis u. des Impferysipels" Habilitations- 
Thesis, 1880. (Aerztl. Vereinsbl. 1S79). 
Epidemic of vaccino-syphilis at Brandenburg, 1S76, 15 school-girls in- 
oculated. (See Epidemics). 

Frezoul, Paul L. H. 

"Des vaccinations precoces et de la syphilis vaccinale." These de Paris, 
1862, pp. 40*. 

Friedlander, M. Breslau, (Prof. Neisser's Klinik). 

"Zur Aetiologie der im jugendlichen Alter vorkommenden Syphilis" 
Inaug. Dissert. Breslau, 1884. 

1) Case, double lactation episode, two nurses and one nursling infected 
(Obs. I.). 

2) Case, nurse infected by nursling having acquired syphilis, contracted 
either from a nurse, or by vaccination (Obs. II.). 

3) Case, girl of 9 years, syphilitic after sleeping with a housemaid (Obs. 
III.). 

4) Case, chancre of tongue in a girl who tended an infant (Obs. V.). 

5) Case, sister of preceding, infected from same source (Obs. IV.). 

6) Cases, two children, 9 and 10, infected from a foster-child (Obs. VI., 
VII A 



ANALYTICAL BIBLIOGRAPHY 291 

7) Case, boy of 5, infected by mother, who had relapse of syphilis (Obs. 

VIII.). 

8) Family epidemic, originating from a nursling (Obs. IX., X., XI.). 

9) An episode analagous to preceding (Obs. XII., XIII.). 

10) Case, chancre of lip in an infant, probably infected by mother (Obs. 
XV.). 

11) Case, recent acquired syphilis, in boy of 5, source unknown (Obs. 
XVI.). 

12) Case, recent acquired syphilis, in boy of 8, source unknown (Obs. 
XVII.). 

13) Cases, two young infants, sisters, acquired syphilis, mother syphilitic 
(Obs. XVIII. , XIX.). 

14) Case, chancre over zygoma. 
Fritze, F. Berlin. 

Annalen, X., 116-118 (Plouquet). 

Case, inoculation of a patient by phymosis operation. 
Froelich, J. Vienna. Prof. Neumann's Clinic. 
Allgem. wien. med. Zeit. 1889. 

1) Case, chancre, right nipple, nurse from nursling, p. 79. 

2) Case, chancre, upper lip and right ala of nose, in female of 20 years, 
p. 79. 

3) Case, chancre, lower lip, female 38 years, source unknown, p. 79. 

4) Case, chancre, right forearm in female of 24, from washing soiled 
linen, p. 79. 

5) Case, chancre, left tonsil in female of 30, from a spoon, p. 79. 

6) Case, chancre, right wrist in a man from a bite (not personal). 

7) Case, chancre, nipple, 15-year-old virgin, from a bite (not personal). 

8) Case, chancre, lip, from chewing cigar stumps (not personal). 

9) Case, chancre, lip, from kissing (not personal). (See Neumann). 

Froloff. St. Petersburg. 

Vratsch, No. I., p. 21. (Annales de Derm, et de Syph., 1891, p. 237). 
Case, chancre, right lower eyelid, near outer canthus, in man of 23 years, 
probably from a towel. 

Fuchs, C. H. Gottingen. University Prof, of Medicine. 
" Krankhaf te Verand. d. Haut ". 1840. 

1) An account of the Disease of St. Paul's Bay, (p. 751). 

2) Epidemic of. Syphilis in obstetrical ~ractice, 1737, Hungary (p. 770). 
(See Epidemics). 

"Die altesten Schriftstellen iiber die Lustseuche in Deutschland," 
Gottingen, 1843. 

3) Contains many statements of various writers regarding extra-genital 
infection. 

Gabalda, F. Paris. 

"De la contagion de la syphilis secondaire," Paris, 1859. 
Case, chancre upper lip from kissing, woman infects lover (p. 4). 

Gailleton, A. Lyons. Surgeon-in-Chief, Antiquaille. 

Cases of lactation and glass-blowers syphilis. (See Rollet, Roussel). 

Galezowski, X. Paris. 

" . . . . Amblyopies et amaur. syph." Archiv. gen. de Med., 1871, I., 

(P- 177)- 

1) Case, chancre of nipple. 

2) Case, chancre of lip, child of preceding. 
Journ. d' Ophthalmol., Paris, 1872, I., p. 308. 

3) Case, chancre of eyelid, source unknown. 
Receuil d' Ophthalmol., Paris, 1882, p. 604. 

4) Case, chancre of eyelid and globus oculi. 

Reported by De Beck q. v. p. 50 (personal communication). 



292 SYPHILIS INSONTIUM 

5) Two cases, m 1882 and 1885, chancre of eyelid from contamination 
of fingers. 

6) Two cases, 1882, 1886, chancre of eyelid, contamination of tongue. 

7) Three cases, possibly the above, Lavergne and Perkin q. v. 3 . 

Galippe. Paris. 

Annales d' Hygiene publ., 1879, I., p. 243. 

Refers to the possible transmission of syphilis by means of toys, blown 
with the mouth, after others with mucous patches, but gives no cases. 
Gallia. Turin. 

Congress Italian Physicians, Peruggia, 1885 (Monatsh. f. prakt. Derm., 
1885, p. 434V 
Epidemic of vaccino-syphilis, from a congenitally syphilitic nursling. 
Galligo, I. Florence. 

Trattato teor.-prat. sulle Mai. Ven., Firenze, 1S64 (also Gaz. hebdom. de 
Paris, i860, July 27, Aug. 10). 

1) Epidemic of vaccino-syphilis atRufmo, 1856, p. 746. (See Epidemics). 

2) Case, infection from kissing, (p. 733). 
(Cited by Profeta without reference). 

3) Case, midwife infected professionally. 
Gallus, A. (or Lecoq). Paris. 

" De ligno sancto non permiscendo," 1540; Aphrodisiacus, ed. 1728, p. 
463. (Rosen von Rosenstein " Kinder kraakheiten," Gottingen, 179S, 
p. 728). 
Inoculation of midwife professionally. 
Galvin, Geo. W. Boston. 

New York Med. Journ., June 11, 1887. 

Case, inoculation own left index finger in sewing wound on syphilitic. 
Gamberini, P. Bologna. Osp. St. Orsola; and Univ. Clin, for Vener. Dis. 
" Manuale delle malattie cutanee," Milano, 1871, p. 293. 

A brief description of " Frenga." 
"Rapporto di un decennio di clinica." Giorn. ital. d. mal. ven., etc., 
1875 (p. 227, 228). 

1) Case, chancre of lip in a youth, from kissing. 

2) Case, chancre of upper lip, in male, from a cigar. 

3) Case, chancre of chin. 

Giorn. ital. d. mal. ven., etc., 1878, p. 365. 

4) Two cases, chancre of right cheek, and of the neck, from bites. 

5) Case, chancre upper lip, about to be removed for cancer. 
Giorn. ital. d. mal. ven., etc., 1882, p. 129-137. 

6) Six cases, extra-genital chancres, reported by Caramitti (q. v.). 
Giorn. ital. d. mal. ven. etc., 1885, p. 267. 

7) Case, chancre of hand, from a bite, reported by Bucci (q. v.). 

Garnet. Givors. 

Reported in Gaz. med. de Lyon, 1867, by Diday, 10 and Guinand ' (q. v.). 

1) Case, of glass-blower's syphilis. 

2) Case, child of the above. 

3) Case, nurse from above nursling, causing suit for damages, award of 
1500 francs. 

Gardane, J. J. Paris, Chief of Bureau of Nurses. 

Gazette, 1775, p. 30 (Plouquet, Index Lit. Med. Digesta). 

1) Epidemic, obstetrical, midwife infected, infects clients. (See Epi- 
demics). 

2) Case, nurse infected by nursling, recovers damages 

Garreau, M. Paris. 

(See Fournier "Chancre cephalique," 1S58, cases furnished by thirteen 
physicians, mostly ex-internes of venereal hospitals). 
Case, chancre of lip. 



ANALYTICAL BIBLIOGRAPHY 293 

Garson, G. London. 

" Contagion of secondary syphilis." Lancet, Dec, 1848, II., p. 640. 
Family epidemic, four children infected by parents. 
Gascoyen, G. London, Lock Hospital, Surgeon. 

Med. -Chirurg. Transactions, 1875, LVIII. (Cases of reinfection). 

Case, chancre of thumb (physician ?), from contact with patient, case 
IV. 
Gaudichier, H. J. Paris. 

" De l'echeance des accidents cerebraux de la syphilis," 1886. 
Case, phagedenic chancre of lip, followed shortly by hemiplegia (Obs. 
III., p. 126). 
Gauducheau. 

"Un cas de chancre syph. de l'amygdale droite" Journ. demed. de l'ouest. 
Nantes, 1887, 3d ser. I., p, 88-95.* 
Gauthier, L. P. A. Lyons. Hosp. de l'Antiquaille, Surgeon. 

"Observ. prat. s. 1. mal. vener., trait, par l'iod. de potass." 1845 
Case, nurse infected by nursling. 

Gautier, Eugene. 

" Sur la syphilis vaccinale." These de Paris, 1866 (p. 36).* 

Gav«> H. Belfast. 

Lancet, July 18, 1846. II., p. 62.* 

Case, nurse infected by syphilitic nursling (see Egan 4 ). 

Gay. 

Boston Med. Soc, Jan. 25, 1858; Boston Med. and Surg. Journ. Vol. 58, 
p. 163. 
Case, chancre of the end of finger. 

Gay, A. H. Kasan, Russia. 

Protocol, first congr. Russian Phys., St. Petersburg, 1886 (p. 43-45). 

1) Two cases of chancre of tonsil, seen in 14 years. 

"Lectures on syphilitic and venereal diseases," Kasan, 3d ed., 1888. 
(Viertelj. f. Derm. u. Syph., 1890, p. 501). (See also British Journ. of 
Derm., Vol. I., 1889, p r 424). 

2) Statistics of extra-genital chancre: 8.9 per cent, (males 3.8; females 
18.9). 

3) Total personal cases 118: lips 39, eyelids 4, nose 4, cheeks 2, chin 2, 
pharynx 14, breast 13, trunk 32, legs 4, fingers 2, arm 1, anus 1. 

Gayet. Lyons, Surgeon to Hosp. de l'Antiquaille. 

Case, chancre of forehead, in site of a dog bite (Jullien, 1886, p. 588). 

Geber, E. Vienna. 

Viertelj. fiir Derm. u. Syph., 1875, p. 445. 

"Aleppo boil" : a term used to represent chronic ulcerative lesions, largely 
syphilis, lupus or scrofula. 

Geigel, A. Wurzburg. 

"Bernard Holzheuscr, etc.," Viertelj. f. Derm. u. Syph., 1S71, p. 397. 

1) Epidemic of syphilis from cupping, 1615, at Sommerach, Franconia; 
reproduction of the forensic documents. 

"Geschichte, Pathologic und Therapie dcr Syphilis," Wiirzburg, 1867. 

2) Cases of PoiLROUX, earliest known of infection by tattooing (p. 223). 

Gemma, A. M. Verona, Italy. 

Giorn. ital. d. mal. ven. c d. pelle, 1873, p. 207; 1S74, pp. 22, 344; 1S75, p. 
153; 1876, pp. 3, 203; 1877, pp. 141, 235. 

1) Twelve eases of syphilis insontium, mainly from nursing and family 
propagation. 

Giorn. ital. d. mal ven. e d. pelle, 18S3, p. 294. 

2) Case, nurse infected by nursling. 



294 SYPHILIS INSONTIUM 

Gemy. France. Prof. Medical College of Algeria. 

Annales de Derm, et de Syph. Vol. I., ser. III., 1890. 

1) Case, chancre of left nares, source unknown (p. 571). 

2) Case, chancre of lower lip, source not stated (p. 579). 
Genters, W. 

Der Morbus Dithmarsicus. Dissert. Inaug., Kiel, 1878. 
Gery. Paris. 

Case, chancre of the hand, from bite (see Beauvais 2 ). 
Gibert, C. M. Paris. Hop. Lourcine; Hop. St. Louis. 

"Manuel pratique des malad. vener." Paris, 1837. 

1) Small family epidemic from lactation (p. 325). 

2) Case, nursling infected by nurse, chancre of lip (p. 637). 

3) Case, nursling bites mother's nipple and a chancre develops; at same 
time infant shows signs of syphilis (p. 638). 

4) Case, syphilis d'emblee in woman, bottle-feeding an infected child; 
own child, chancre of lip (p. 638). 

Bull de l'Acad. de med. Paris, Sept. 28, 1852. (Reference of Putegnat). 

5) Case, chancre of tonsil, in a pregnant woman. 

"Traite prat, des malad. d. 1. peau et de syph." 3d ed. Paris, i860. 

6) Case, chancre of tonsil, from forcible kissing (p. 14). 
Gibier-de-Savigny. Paris. Hop. du Midi (Service of Horteloup). 

L'Union med., t88o. 3d Ser., XXX., No. 127, p. 523, 
Case, chancre of the septum narium. 
Gilbert, A. Paris. Hop. des Veneriens. 

Case, nurse infected by nursling (reported by Vassal 3 , q. v.). 
Gilchrist, E. 

" An account of a very infectious distemper prevailing in many places." 
Essays and Obs. Phil. Soc, Edinb,, 1771, iii., 154-177* (quoted by 
Boeck, "Traite d. 1. Radesyge," etc., i860, p. 49). 
A personal account of Sibbens. 
Gillebert-D'Hercourt, fils. Paris. 

Annales de Derm, et de Syph., 1880, p. 746. 

Case, chancre of upper gum, between median incisors. 
Gilles de la Tourette and Hudelo. 

Annales de Derm, et de Syph., Vol. III., June, 1892, p. 686. 
Case, probable chancre of tonsil in man of 37, cause not stated. 
Giovannini, S. Bologna. Prof. Gamberini's Univ. Clinic for Skin and 
Venereal Diseases. 
" Contribuzione alia Statis. dei Sifilomi inizioli Extra-genitali." Lo Speri- 
mentale, 1889, No. 9 (p. 262). (Archiv f. Derm. u. Syph., Vol. XXII., 
1890, p. 276). 

1) Ten cases, chancre of the lip. 

2) Case, chancre of lower lip, from wound by dental instrument. 

3) Case, chancre of lower lip, in woman, from gnawing chicken bone 
after her syphilitic son. 

4) Seven cases, chancre of breast, nurses from nurslings. 

5) Four cases, chancre of chin. 

6) Two cases, chancre of cheek, one of which was from razor inoculation, 

7) Two cases, chancre of thigh. 

8) Case, chancre of lower eyelid. 

9) Three cases, chancre of the trunk. 
10) Case, chancre of finger from a bite. 

Girode. Paris. Hop. St. Louis. (Service of Lailler). 

"Chancre syph. developpe sur lis lesiones d' une Gingivite phosphoree," 
France Medicale, Paris, 188S, I., p. 397. 
Case, chancre of gum, in 22-year-old girl, working in match factory, 
from drinking-glass. 



ANALYTICAL BIBLIOGRAPHY 295 

Girtanner, Chr. Gottingen. 

Abhandl. ii. d. vener. Krankh., Gottingen. Vol. I., 1797 (3d edit.). Vol. 

II.. III., 1793 (2d edit.). 
The last two volumes consist of an analytical bibliography of 1912 works 
arranged chronologically, and numbered consecutively: these numbers 
are referred to when quoting Girtanner. 
Glasunowski, V. 

Wratchebnyja Wiedomosti, 1882, No. 507 (Russian) (Archiv f. Derm. u. 
Syph., 1889, p. 240). 
Statement; among 3012 syphilitic patients in the district of Voronesch 
(South Russia), there were 331 boys and 332 girls, from one to ten 
years of age affected with mucous patches. 

Glatter. 

Oesterr. Zeitschr. f. prakt. Heilk., 1862, VIII. 4. (Schmidt's Jahrb., 1863. 

Vol. CXX., p. 106). 
Epidemic of vaccino-syphilis at Csomad, Hungary. 
Midwife, chancre of arm, infected grand-child : many vaccinated from 

child became syphilitic, many nursing mothers acquired chancres of 

breast, and others from family utensils ; finally, 72 persons became 

syphilitic. (See Epidemics). 

Glauert. 

Berlin, klin. Wochen., 1882, No. 49, p. 751. 

Case, chancre, right tonsil, in man of 25 years, source unknown. 

Gluck. Cracow. Univ. Clinic for Syphilis. 
Wiener med. Presse, 1881, No. 32. 

1) Statistics, Hop. St. Lazare, 1873-8: chancre, breast, 8 cases. (Service 
Prof. Zarewicz, q. v.). 

Wiener med. Presse, 1888, Nos. 27, 28. 

2) Case, chancre of hairy scalp, 

3) Case, chancre, naso-labial fold, both from shaving by syphilitic 
barber. 

4) Case, chancre of lip, 5-year-old child, from neighbor's spoon. 

5) Case, chancre of lip, boy of 9, from chewing lead pencil of class-mate. 

6) Case, chancre of tonsil, woman, from kissing female friend. 

Gnocchi, G. 

Indipendente, Torino XXXIII. p. 145-157. 
Epidemic at Romentino di Novara, 1 880-1 (known only by title). 

Goldenberg, H. New York. 

Scientific meeting of German Physicians of New York, Nov. 28, 1S90. 
New Yorker med. Monatschrift, Feb. 1891. 

1) Case, chancre of elbow, after trauma. 

Scientific meeting of German Physicians of New York, Nov. 1891. New 
Yorker med. Monatschrift, Mar., 1892. 

2) Case, chancre, prepuce and glans penis after circumcision. 
Scieniific meeting of German Physicians of New York, Mar., 1892. New 

Yorker med. Monatschrift, Aug., 1892. 

3) Case, chancre, left lower eyelid, cause not ascertained. 
Presented at the Scientific Meeting of German Physicians of New York, 

Sept. or Oct., 1890 (unpublished). 

4) Case, chancre, cheek, after shaving. 

Gondonin, A. Argentan. 

L' Union med. Paris, 1869 (P- 553)- 

Case, chancre of tonsil, nurse from nursling (see Appay 5 ). 

Goodell, Wm. Philadelphia. Prof, of Gynecology, Univ. of Penn. 

"The danger of Syphilitic Infection by Gynecologists." Annals of 
Gynecol, and Pediatry, 1890, III., p. 262. 



296 SYPHILIS 1NS0NTIUM 

1) Case, chancre of finger, in student, acquired while working in ven- 
ereal wards. 

2) Case, chancre of finger, in physician, from delivering a syphilitic 
woman. 

3) Two other cases, syphilis in physicians, from midwifery practice. 

4) Case, chancre of tonsil, in a lady, source of infection unknown. 
Gosselin. Paris. Surgeon to Charite. 

1) Case, chancre of septum narium (see Dulac). 

2) Case, chancre of eyelid (see Guignard 6 ). 

3) Case or cases, of Eustachian-infection, according to Jullien 7 and 
others ; not known if ever reported. 

Gottheil, W. S. New York. 

New York Med. Journ., Mar. 19, 1892, p. 327. 

Case, chancre, upper lip, in girl of 19 years, cigar finisher, acquired 
probably in drinking from same cup with another girl with a similar 
sore on the lip. Both finished the cigars by moistening the ends 
with saliva. 

Gould, A. P. London. 

Lancet, 18S2, II., p. 777. 
Case, chancre of cheek. 
Graarud, P. 

Tidskrift for prakt. med., 1886, No. 20, Aug. 5. (Viertelj. f. Derm. u. 
Syph., 1887, p. 385)'. 
Family infection ; a family of three receive each chancre of throat, from 
pipes or glasses. 

Grafe-Samisch's Handbuch der Augenheilkunde, 1875, Bd. IV., p. 417. 
(Archiv f. Derm. u. Syph., Vol. XX., 1888, p. 16). 
Case, chancre of eyelid. 

Grancini and Dall'Acqua. 

"II vaccino ammale ed il vaccino umanizzato," Milan, 1879. (Cited by 
Sormanni, q. v.). 
Epidemic of vaccino-syphilis ; 1873 at Bardelle, Bergona and other places. 
(See Epidemics). 

Grandmond, G. de. 

Journ. de Med. de Paris, 1886, No. 12. 

Case, chancre of conjunctiva, woman 26 years old, source unknown. 

Gratia, V. Brussels. Hop. St. Pierre (Prof. Thiry). 

Presse med. Beiges, Bruxelles, XXX., 1878, pp. 257-2S1. 

1) Case, chancre of eyelid in woman; husband, chancre of lip, commis- 
sure — infected by kissing. 

2) Case, chancre of eyelid, probably from digital auto-infection after 
venereal exposure. 

3) Case, alleged multiple chancre on different regions of body, one on 
eyelid. 

Greenleaf. United States Military Surgeon. 

Case, chancre of lip in a musician, from mouthpiece of a cornet. (See 
Arthur 4 ). 

Griffin, E. H. New York. 

Reprint from N. Y. Med. Record for Aug. 22d, 1891 and Oct. 1st, 1892 

(P- 393)- 

1) Case, chancre lower lip near centre in boy of 9 years, drinking from 
tin beer pail used in common by several workmen (p. 3). 

2) Case, chancre right tonsil in 12-year-old brother of above from stick 
of candy sucked by the former (p. 5). 

3) Case, chancre middle of upper lip in 15-year-old sister of above boys 
from kissing them (p. 6). 



ANALYTICAL BIBLIOGRAPHY 297 

4) Case, chancre of right tonsil in boy of 8 years from unnatural 
practices (p. 7). 

5) Case, chancre lip in actress of 24 years from rouge used in common 
with fellow-actress with syphilitic sore mouth, it was rubbed on 
the lips with the finger (p. 7). 

6) Case, chancre lip in girl of 18 years from kissing (p. 7). 

7) Case, chancre lip in young married woman of 23 years, husband had 
fever blisters (p. 7). 

8) Case, chancre upper lip in man of 42 years, drinking whiskey in 
common from flask (p. 8). 

9) Case, chancre under surface of tongue in female, husband had 
mucous patches in mouth (p. S). 

10) Case, chancre upper lip in married woman of 28 years, from husband 
by kissing (p. 3). 

11) Case, chancre lip in woman, from her husband (p. 8). 

12) Case, chancre lip in female cook, from kiss of lover (p. 8). 

(The above twelve cases were total number extra-genital chancres observed 
among 1,200 cases of syphilis examined). 

13) Case, chancre lip in woman from husband by kissing (p. 15). 

Griffith, A. H. Manchester, Assist.-Surg. Royal Eye Hospital. 

" Syphilitic lesions of the eyelids.'' Med. Chron., 1886. Vol. IV., No. 3 
(p. 193). (Jahresber. f. Ophth., 1S86, XVII., pp. 250-441). 
Nine cases, chancre of eyelid. 

Grigorov, S. W. Moscow, Mjasnitsky Hospital. 

Protoc. d. Conf. d. Aerzte d. M. Krankenhaus, 188c. 
Case, chancre of right tonsil, in an attendant. 

Groedinger, R. Riga. Royal Alexander Hospital. 

Report of Syphil. Division of the Hospital, Riga, 1885. (Cited by Peter- 
sex, q. v.). 
Statistics among 231 cases: chancre of lip 2, of finger 1. 

Gromier. Givors. 

(Cited by Guinand, q. v., from original mention in Diday's Gaz. med. de 
Lyon). 
Three cases, chancre of lip, in glass-blowers, Givors, 1875. (Seen by 
Gromier and Diday). 

Gros, F. Nancy. Prof. Clinical Surgery. 

" Sur le chancre de la bouche." Rev. med. de l'Estrange, 1S79, XI. 

(P- 145). 
Case, chancre of lip, in an omnibus conductor, from use of whistle. 

Gross, S. D. Philadelphia, U. S. A. Prof, of Surg., Jefferson Med. Coll. 
Address in Surgery. Transac. Amer. Med. Assoc, Vol. XXV., 1874, 

P. 255- 

1) Case, chancre of lip in young lady, from her betrothed, afterwards 
husband. 

2) Two cases, medical men professionally infected and in turn infected 
their wives. 

3) Statement, without documents; has seen many cases of infection 
from kissing. 

4) See also Price, J. H. 

Gninfeld, J. Vienna. 

" Ueber Vererbung u. Uebertrag. von Syph. bei Neugeborcncn, "Wie- 
ner med. Presse, 1879, XX., p. 1492. 

1) Case, chancre of scalp in an infant, mother infected about middle of 
pregnancy; child infected from mother's parts during parturition. 

Verb. d. Wien. derm. Gesellsch. (Viertelj. f. Derm. u. Syph., 1892 p. 181). 

2) Case, chancre of tongue, man of 45 years. 



298 SYPHILIS INSONTIUM 



Gruner, C. G. Jena. 

" Die ven. Ansteck. d. gemein. Trinkgesch. , u. durch dengemein. Kelch., 
etc." Leipzig, 1787 (Rosen von Rosenstein " Kinderkrankheiten," 
Gottingen 1798, foot-note, p. 729); also Almanach f. Aerzte u. 
Nichtaerzte, Jena, 1785. 
Several cases of infection from drinking-glasses. 

Gubler. Paris. Univ. Prof, of Therapy. 

" De la syphilisation, etc." Acad, de med., 1853 (p. 284). (Cited by 
Ricord, q. v.). 

1) Case, chancre of eyelid. 

L'Union med., Paris, 1864, No. 129 (p. 217) (Soc. med. des H6p.). 

2) Two cases, chancre, from Eustachian catheterization (one with Sou- 
chard). 

3) Two cases, chancre, from Eustachian catheterization (one with 
Ricord). 

Gueniot. Paris. Hop. des Enfants. 

Case, infant infected by kissing another infant. (See Pontet). 

Guenzberg, C. Moscow. Royal Foundling Hospital. 

Oesterr. Jahrb. f. Padiat. II., 1872. (Viertelj. f. Derm. u. Syph., 1873, 
p. 604). 

1) Case, chancre of the tongue in a nursling. 

2) Case, another nurse infected by preceding nursling. 

3) Three nurslings, infected from a single nurse. 

Guerrier. 

Ann. d' hyg., Paris, 1881, 3d Ser., VI., p. 64. 
Case, nurse infected by nursling. 

Guevin, A. Paris. 

Bull, de l'Acad. de med. de Paris, 1869, XXXIV., p. 512. (Gaz. des H6p., 
July 15, 1869). 

1) Case, chancre of the arm in a child from vaccination. . 
Models in Hop., St. Louis. (See Guignard). 

2) Case, chancre of lip, 1868; chancre of nose, 1870. 

Guibout, E. Paris. Hop., St. Louis. 

1) Case, chancre of lip, from a drinking-glass. (See Ory 8 ). 

2) Three cases, chancre of lip. (See Zwetitch). 

3) Case, chancre of tonsil. (See Le Gendre '). 
Models, Hop. St. Louis. (See Guignard). 

4) Case, chancre, angle of mouth, 1871. 

"Nouv. Leeonsclin. sur les mal. d. 1. peau," 1879, p. 154. 

5) Case, mother infected by own child, hereditarily syphilitic. (Excep- 
tion to Colles' law). 

Guignard, C. Paris. 

"Contribution a 1' etude des chancres syph. extragen." "These de Paris, 
1882, No. 97. 

1) List of the models of extra-genital chancre at the Hop. St. Louis (p. 
15, 21, 24, etc.). 

2) Case, of Vicente, chancre in centre of each cheek (pp. 17, 19). 

3) Case of Mericamp, chancre of tongue, from a tobacco-pipe (pp. 19, 21). 

4) Case of Fournier, chancre of nose, from a bite (p. 24). 

5) Case of Mericamp, chancre of forehead in site of wound by a board; 
probably infected by one who dressed it (p. 26). 

6) Case of Gosselin, chancre of eyelid, source unknown (p. 27). 

7) Case of Depres, chancre of little finger, from bite (p. 47). 

8) Case of Fournier, chancre of tonsil, young virgin, source unknown 

(P. 53). 

9) Case of Martineau, chancre of mouth from speaking-tube (p. 17). 



ANALYTICAL BIBLIOGRAPHY 299 



Guillery. Brussels. Univ. Prof, of Forensic medicine. 
Gazette Obstetricale, 1879, p. 103. 
Case, nurse infected by nursling. 

Guinand, J. Rive-de-Gier. 

" De la Syphilis des verriers, hvg. et prophyl. par la visite sanit." Paris. 
1881. 

1) Cases of Gamet of Givors, reported by Rollet, 1867: child of one of 
the workmen, infected a wet-nurse, who recovered damages, 1500! , 
at the tribunal St. Etienne (p. 29). 

2) Epidemic of Montlucon, cases of Dechaux, q. v.: in 1S6S, new cases 
appeared, but only in the wives or new-born children, as the com- 
munity were on their guard (pp. 29-31). 

3) Two cases, at Rive-de-Gier, 1872, each chancre of lip: sanitary visits 
were instituted at this factory and no further cases occurred (pp. 

31-33)- 

4) Case, infection of glass-blower per os, 1S75, at Rive-de-Gier (p. 33). 

5) Three cases of same at Givors, 1875. Dr. Gromier; seen in consulta- 
tion by Did ay (p. 33). 

6) Case, chancre of lip, at Rive-de-Gier, 1879 (p. 33). 

(See Besnier, remarks when prix Vernois was awarded this essay). 

Gulli, A. Palermo. 

" Prostituzione in Sicilia." Vol. I. Palermo, 1863: Vol. II. Torino, 1865. 
(noted in Giorn. ital. dell. mal. vener. e d. pelle, 1865, I., 157; 1866, 
I., 286). 
Epidemic character of Syphilis in Sicily during the cholera of 1837. 

Guntz, J. E. Dresden. 

" Bericht iiber die ersten fiinf Jahre des Bestehens der offent. Polik. f. 
Hautk. u. Syph." Dresden, 1869-1874. 

1) Case, chancre of lip, in 6-year-old boy, from drinking-glass. 

2) Seven other cases, chancre of the lip. 

" Ueber Verhiitung der Syphilis," Leipzig, 1870. 

3) Case, infection of a gynecologist (p. 59). 

4) Case, infection of a physician from a newly-delivered child (p. 59). 

5) Case, infection from a musical instrument (p. 90). 
G) Case, chancre of the lip, in a flower-maker (p. 92). 

7) Case, infection by kissing (p. 25). 
Deutsche med. Wochenschr., June 28, 1879, p. 337. 

8) Case, chancre of lip, in a 9-year-old girl. 

" Ueber die Syphilis der Schuikinder." Memorab., Heilbronn, 1879, XXIV., 
No. II. pp. 503-507. 

9) Eight cases of acquired syphilis in school-boys. 

*' Chromwasser-behandl. der Syphilis," Dresden, 1883. 

10) Case, chancre of lip from kissing. (Obs. 91, p. 125). 

11) Three cases, chancre of lip, source unknown. (Obs. 215, 272, 387). 

12) Case, inveterate syphilis, ascribed to infection from washing foul 
linen. (Obs. 223). 

13) Family epidemic one of the victims a boy of 13 years, (Obs. 225). 

14) Case, child of 4 years, infected 3 years beforeby her sister. (Obs. 299). 

15) Case, midwife professionally infected, lung syphilis after 10 Years. [ 
(Obs. 356). 

16) Case, infection of a girl per os, from kissing. (Obs. 361). 

17) Case, infection of an infant by its mother, seen 9 years after. (Obs. 
369). 

Guranowski, L. 

" Przypadek Shankra u uchu Szednim." Gaz. lekarska, Warsaw, 1SS6, 
2d Ser. VI., pp. 390-393. 
Case, chancre in the middle ear (case criticised later by Heiman, Viertelj. 
f. Derm. u. Syph. 1887, p. 387, as not chancre but tertiary disease). 



3°° SYPHILIS INSONTIUM 

Gurovitch, S- A. Odessa. 

Meditzinskoie Obozrenie, 1892, No. 6, p. 521. 

1) Case, chancre of lip in 19-year-old nurse, from nursling. 

2) Statement: observed several cases of acquired syphilis in children. 
Guttceit, H. von. 

" Geschichte eines (primar-syphilitischen) Lippen geschwiires." Med. 
Zeitz. -Russlands. St. Petersb., 1852, No. 41.* 
Case, chancre of lip. 
Guyenot, J. F. Lyon. 

41 De i'inoculab. de la syph. constitu.'' These de Paris, 1859. 
Two cases of Lecoq of Cherbourg, Vaccino-Syphilis. 
Guyon, L. Lyon. 

"Lemiroir delabeaute," 161 5, T. II. , p. 22(Cazenave, "Traitedes Syph.," 
1S43, p. 114). 
Four apprentices infected from master, through bedding. 
Haase, C. F. Dresden. 

"De syphilidis recens natorum pathogenia," Dresden, 1828 (Allgem. med. 
Annal., 1829, p. 194). 

1) Case, nurse receives from nursling lesions which were probably 
syphilitic (p. 17). 

2) Case, nurse infected by nursling (p. 19). (Reported by Ruthenberg, 
q. v.). 

Hacker, H. A. Leipzig. 

1) " Literatur der syph. Krankh. vom. J. 1794-1829." Leipzig, 1830 
(intended as a continuation of Girtanner's Bibliography). 
Many citations in present Bibliography are on authority of Hacker. 

2) "Die Ansteckungsf. Syph. secund Syph. modificata," Schmidt's 

Jahrb., 1851, LXXIL, p. 103. 
Treats of various forms of modified syphilis, in different countries; Syphi- 
loid of Van Deurs, Radesyge, Scherlievo, Facaldina, Frambcesia, 
Sibbens, Spyrocolon, etc. 
Hairion, F. Lourain. Prof, of Ophthalmology. 

"Bubo preauricular, a new diagnostic sign in venereal ophthalmia. '* 
Ann. d'oculistique, 1846, XV., pp. 156, 236. 
Case, chancre of eyelid (see Cunier 2 ). 

Hallopeau. 

Model in Musee de l'Hop. St. Louis (Annales de Derm, et de Syph.,, 
August, 1892, p. 951). 

1) Case, chancre of anus, developed upon site of hemorrhoids. 

2) Case, chancre, back of hand. 
Hamande. Brussels. 

Archiv. med. Beiges, Bruxelles, 1879, 3 S,, XV., 194-197. 

Case, chancre of lower eyelid in a laundryman, employee in laundry of 
syphilitic ward. 
Hamerton, C. Dublin. Surgeon to Castletown Dispensary. 
Dublin Journ. of Med. Science, Mar., 1841, No. 55, p. 34. 

1) Two cases, mother and child from nursling and nurse, her sister. 

2) Case, chancre of lip, in servant of above, from drawing her breast. 

3) Case, chancre, palm of hand, in midwife, during delivery of No. 2. 
Hamilton. Dublin. 

1) Case, syphilitic inoculation by tooth implantation (see Lettsom 2 ). 
Dublin Med. Journ.. 1848, XX., p. 511. 

2) Case, syphilis acquired in infancy. 

Hardh, C. W. Wadstena. Hosp. for venereal diseases. 

" Observ. nonnullae medico-pract." Londini Gallorum 1797, Hacker (p. 13). 
Statement- women and children are infected thrice as often as men, on 
account of promiscous lactati< n. 



ANALYTICAL BIBLIOGRAPHY 301 

Hardh. J. O. Tavastehns, Finnland. 

" Nagra Fall of Syphilisinfection genom Koppening" Finnskalak, Sallsk., 
Helsingfors, 1873, XV., p. 51. 
Epidemic from wet-cupping, at Tavastehus, 1872, fourteen infected. 
(See Epidemics). 
Hardie, G. Surgeon-Major, Army of Great Britain. 
Report of Army and Navy Commission, 1S67. 

Case, chancre of finger, in medical man, from operation for fissure in 
ano (p. 162). 
Hardy, A. Paris. Hop. St. Louis and Charite. 
Gaz. des Hop., Paris, 1865, p. 445. 

1) Case, chancre of tonsil from lozenge (see Valcourt and Murray). 
Gaz. des Hop., Paris, 1878, No. 105, pp. 833-835. 

2) Case, chancre, ri^ht tonsil, in man 35 years old, probably by Eusta- 
chian catheterization. 

(Reported, 1875, by Ory, q. v. These de Paris). 

3) Case, syphilitic inoculation of a midwife. 

4) Case, chancre of the lip. 

Traite prat, et descr. des mal. de la Peau, Paris, 18S6. 

5) Two cases, chancre of forearm, in nurses (p. 1008). (See Ory 14 ). 

6) Case, chancre, inner angle of eye, in physician, from patient with 
ulcerated throat lesions, coughing in the face. 

7) Statement, no documents ; has seen infection at eye, nostril, lip, from 
pus, etc., on the fingers (p. 118). 

Harsant, W. H. Bristol. 

Bristol Medico-Chirurg. Journ. , 1883, L, p. 97. 
Case, chancre of the lip. 
Hartley, F. New York. 

Journ. Cutan. and Gen. Urin. Dis., Vol. IX. 1891, p. 218. 
Case, chancre in rectum, male, 32 years old, from pederasty. 
Haslinger, A. 

Medical Times and Gaz., 1884. 
Ten cases of extra-genital chancre. 
Haslund, A. Copenhagen. Kommunhospital. 

"Syphil. infect, gjennem Svselget." Hosp. Tidende, Copenhagen, 1885, 
3 R., III. (p. 629) (Monatsh. f. prakt. Derm., 1885, p. 456). 

1) Case, chancre of tonsil, in 20-year-old virgin, from a tooth-brush. 

2) Case, chancre of tonsil in 40-year-old woman, from tending heredi- 
tarily syphilitic child. 

3) Two cases, chancre of tonsil, from kissing. 

Hosp. Tidende, 18S7, V. (p. 217) (Viertelj. f. Derm. u. Syph., 1S8S, p. 642). 

4) Case, chancre of tonsil in 11-year-old child, source unknown. 

5) Case, chancre of tonsil in a chambermaid, source unknown. 
Beret, om Kommun. Hosp. (Viertelj. f. Derm, u. Syph., 1888, p. 641). 

6) Among 44 syphilitic children, seven had acquired syphilis. 
Kommunehospitalets 4, Afdeling I., i89o(Archiv f. Derm. u. Syph. Vol. 

24, 1 892, p. 108). 

7) Nineteen cases of syphilis insontium were treated during the year 
1890. 

Hauff. Besigheim. 

Hufeland's Journ., Berlin, July, 1S34. 
Case of Vaccino-syphilis. 
Hauner. Munich. Children's Clinic. 

"Ueber Syphilis der Kinder." Behrend's Syphilidologie, New Ser., 1858, 
(P- 3 76). 

1) Statistics: syphilis during decennium, 1845-1855. 

2) Three cases of syphilis acquired from foster-mother. (Obs. 5, 6, 60). 

3) Four cases, acquired from father or mother. (Obs. 22, 50, 51, 52). 



302 SYPHILIS INSONTIUM 

4) Case, acquired from grand-mother. (Obs. 45). 

5) Case, supposed infection at anus from sponge. (Obs. 16). 
(All the above from one to three years old). 

6) Case, from sleeping with infected person. (Obs. 11). 

7) Three cases, children slept with a servant. 
Haydon, N. J. Bovey Tracey, England. 

Med. Times and Gazette, London, 1862, L, P- 3*6. 
Two cases of syphilis, in previously healthy children, after vaccination 
from a syphilitic child. 
Hayward, Jr. Boston. 

Boston Med. and Surg. Journ., Vol. LIX., Jan. 6, 1859, P- 457* 

1) Case, chancre of left nipple, nurse from nursling. 

2) Case, infection of child of the above. 

3) Case, chancre of wrist in the grand-mother. 
Healey. Dublin. 

Philosophical Magazine, Vol., XXXIX., p. go. (Colles, q. v. 5 , " Pract. 
Observ.," 1837, p. 14). 
Surgeon infects several parturient women, from secondary sore on finger. 
Hebenstreit, E. B. Leipzig. 

Translation of Bell's treatise on "Ulcers," Leipzig, 1793, note, pp. 311- 
312. 
Case, or cases of nurses infected by nurslings. 
Hebra, F. von. Vienna. Allgem. K. K. Krankenhaus. 
"Dermatol. Abtheilung," Allg. wien. med. Zeit. 1861. 
Case, nurse infected by nursling. 
Hebra, H. von. Vienna. 

Verh. wiener derm. Gesellsch., Viertelj. f. Derm. u. Syph., 1891, p. 831. 
Case, nurse infected by nursling. 
Heiberg, J. Surgeon-in-Chief of the Armies of Denmark. 
Hygien. meddelser (Virchow-Hirsch Jahresbericht, 1883). 
Epidemic at Aalborg, from glass-blowing, nine infected. (See Epi- 
demics). 
Heine, J. Bamberg. 

"Beitr. zur Lehre von der Syph.," etc., Wiirzburg, 1854, 8°, p. 67. 

Epidemic of vaccino-syphilis at Frienfels, Bavaria, 1852, the "process 
Hubner," in which Heine was witness for the state. (See Escherich, 
Heyfelder, Hubner, and Epidemics). 
Heinecken. 

Huf eland's Journal, Vol. VI., 433. 

Epidemic from breast-drawing. (See Epidemics). 
Heisler, I. Budapest (Clinic of S. Rona). 

Orvosi Hetilap., 1S91, No. 8 (Monatsh. f. prakt. Derm. XII., 1S91, p. 419). 

1) Case, chancre of chin, in 23-year-old virgin, from a kiss. 

2) Case, chancre of left tonsil, in 10-year-old boy, from eating or drink- 
ing ware. ■ 

Heister, L. Helmstadt. Univ. Prof, of Medicine. 

"Compend. Med. Pract." Venetiis, 1763 (Girtanner, 978). 
Syphilis acquired from a nurse. 

Heliodore, R. 

" Des differents modes de transm. de la syph. chez les Nouveaux-nes" 
These de Paris, 1852, 48.* 

Helweg. 

Dissertatio de sic dicta Pseudo-Syphilide, praesertim ea, qua? nonnullis 
Morbus Dithmarsiensis audit. Acta regise soc. med. Haven, Vol. 
VI., p. 277 (quoted by Boeck "Traite d. 1. Radesyge" etc., 1S60, 
P- 47)-* 



ANALYTICAL BIBLIOGRAPHY 3° 3 

Henning, J. 

Horn's Archiv., 1822, Bd. 42, p. 403 (Hacker, p. 132). (Dieterich "Die 
Krankheits Familie Syphilis," Landhut, 1S42, Vol. I., p. 137). 

1) Case, alleged transmission by a hat band. 

2) Case, alleged transmission by cigars, infected by the cigar-rollers. 

Henri-de-Saint-Arnould. Paris. 

(Cited by Velpeau, Bull, de l'Acad. de med., 1853). 
Case, nurse infected by nursling. 
Henrot, H. Reims. Faculty Prof, of Therapy. 

Union med. et scient. Nord-est, Reims, 1881, V., p. 243. 

Case, infant infected by div-nurse; also the mother of infant, from the 
child. 
Henry, M. H. New York. State Emigrants Hospital. 

American Journ. Syphilog. and Dermatol., 1S74, p. 354. 

1) Case, chancre of lower lip from kissing, man infected by mistress, 
site of razor cut. 

2) Case, chancre of lower lip, source unknown. 

3) Case, chancre of cheek, from a bite. 

4) Case, chancre back of hand, source unknown. 
Hensler, Ph. G. 

" Geschichte der Lustseuche," etc., Altona, 1783. 

Hentschel, J. G. 

"Diss, de osculo morbifico et mortifero." Halse, 1746. (See Alberti). 

Herard. Paris. 

Gaz. desHop., 1863, p. 497. 

1) Case, chancre at site of vaccination. 
Annales de Derm, et de Syph,, 1887, p. 36. 

2) Case, chancre of nipple, in 63-year-old man, from kissing or bite. 

Hermet. Paris. 

Annales de Derm, et de Syph., 1886, p. 87. 

Case, chancre in furrow behind ear in 24-year-old woman; infection 
from husband. (Service of Fournier). 

Hervier. Rive-de-Gier. 

(Viennois, q. v., "Recherches sur le chan. prim." These de Paris, 1S60, 
p. 65). 
Case, of glass-blower, inoculated by comrade through blow-pipe, seen 
in 1853. 

Hervieux. Paris. 

Bull, de l'Acad. de med., 1888, XXII., p. 116 (L'Union med., 1889 (48), 

p. 226). 

Five cases of vaccinal syphilis : a later report (La Semaine med., 1889, 

No. 50; Viertelj. f. Derm. u. Syph., 1890, p. 692), declares that these 

were not syphilis, but simply ulcerative, with impetiginous sequelae. 

Herzenstein, G. M. 

Vratsch. 1891, No. 18, p. 456 (Monatsh. f. prakt. Derm. XIII., 1891, p. 49). 

1) Of 2i,So8 nurslings, in foundling asylum, 207 had hereditary syphilis; 
from 1881-85, 33 nurses acquired chancre of the breast, and S mem- 
bers of their families became infected ; of 44,728 children in the 
families sending out the other children to nurse, in became infected 
extra-gcnitally. 

"Syphilis in Russia," St. Petersburg, 1885, Vol. I. p. 436. 

2) Statement : syphilis is sometimes spread through vaccination. Dr. 
TcHORZNICKl recently saw a long series of such cases; of 1995 consecu- 
tive cases of syphilis observed by a physician of Rylsk, 4 were of 
vaccinal origin ; two cases of the kind were reported by a practitioner 
of Tatij ; one by Dr. Tchistiakoff ; several by Dr. Vukoloff. The 



3°4 SYPHILIS INSONTIUM 

Svetsch (1882, No. 9) reports the case of an advocate of Kiew who 
contracted syphilis through vaccination, the vaccinator was fined. 
Report of Commission to protect nurses and nurslings against syphilis 
(Vratsch., No. 6, 1891, p. 185). 
3) Statement : syphilization of wet-nurses a most common occurrence in 
private foundling homes in Russia. 
Heurtaux. Nantes. 

Gaz. med. de Nantes, 1883-4, H., p. 83. 

Case, chancre of the lip, removed for epithelioma. 
Hey, T. Leeds. 

Medico-Chirurgical Transactions, Vol. VII. 

Small epidemic from breast-drawing, 1770-71 ; a blind woman acquiring 
chancre of the lip in her occupation, infected others. (See Law- 
rence 5 ). 
Heyfelder, O. Russian Military Service, Surgeon-General. 

" Uebertragung von Syph. durch Kusse." Heidelberger med. Annalen., 
1842, H'ft 4 (Proksch "Die Litteratur iiber die vener. Krankh." 
Bonn., 1891, Erster Bd., p. 327). 
(Reported by Heine, q. v.). 

Episode of vaccino-syphilis at Frienfels, 1852, reported at the trial of the 
vaccinator Hubner. (See Escherich, Hubner, and Epidemics). 
"Ulcere syph. des paupieres." Annales d'oculistique, Bruxelles, 1855, 
XXXIV., pp. 92-100. (Proksch. "Die Litteratur iiber die vener. 
Krankh.," Bonn, 1891, 3te Bd., p. 351). 
Heylen de Herenthals. Antwerp. 

Annal. d. 1. Soc, Med. d'Anvers (Gaz. des Hop., Paris, 1845, p. 315), 
Syphilis in a four-year-old girl, probable chancre of upper lip. 
Hibbert. 

Historical remarks on Yaws and Sibbens, considered as identical affec- 
tions. Edinb. Journ. Med. Sci., 1826, I., 287-290.* 
Hildanus, F. Berne. 

(Cited by Acton, Behrend's Syphilidologie, Vol. III., 1841, p. 513). 

1) Case, chancre, acquired from wearing infected pantaloons. 

(Cited by Rosen von Rosenstein "Kinderkrankheiten," Gottingen, 1798, 
p. 727). 

2) Case, infection from sleeping with a syphilitic man. 

3) Case, infection of young chambermaid from wearing stockings of a 
syphilitic child. 

Hill, B. London. Lock Hospital, Univ. Prof, of Surgery. 

Lancet, London, 186^, I., p. 696, also "Syphilis and local contagious 
disorders," Phila., 1869 (p. 57). 

1) Case, chancre of cheek, from inoculation of wound by suction to 
prevent a black eye. 

2) Case, nursling infected by nurse. 

" Syphilis and local contagious disorders,'' London, 1881. 

3) Case, chancre of gum, from using a towel (p. 34). 

4) Case, chancre of mouth, nursling from infected nurse-mother (p. 70). 
Hillairet, J. B. Paris. Hop. St. Louis. 

Soc. med. des Hop., discussion on Eustachian infection. L'Union med. 
XXIV., 1864 (p. 216). 

1) Case, of Eustachian infection, in a pharmacist. 

2) Case, of same in an old lady, over sixty. 

3) Three other cases, not particularized. 

(For other cases of Hillairet, see A. Cullerier, Fournier, and Jullien). 
Hime. Sheffield. 

" Extensive diffusion of Syphilis traced to a midwife," Brit. Med. Journ., 
1883 (p. 128). 
About 30 married women infected by a midwife: 9 husbands then 






ANALYTICAL BIBLIOGRAPHY 305 

infected by their wives, and also two infants (the same epidemic in the 
courts) p. 335. (See Epidemics). 
Hjelt, O. Helsingfors. Univ. Prof. Legal Medicine and Hygiene. 
41 Die Verbreitung d. vener. Krank. in Finnland," Berlin, 1874. 

1) Epidemic of syphilis from cupping at Hakola, 1858 (p. 14). 

2) Epidemic of same at Topparla, about the same time. 

3) Epidemic of same at Uleaborger, i860. (See Epidemics). 
Hjort, J. J. Christiania. Rigs Hospital. 

Bidrag til Kundskob om de Endemiske Hudsygdomme. Norsk, mag. f. 
Laeger, 1840, I., 1-25, (Trans, in Zeitsch. f. d. ges. med., Hamb., 1841, 
XVI., 1-22, also quoted in Boeck "Traite d. 1. Radesyge," etc., 1860, 
p. 23).* 

1) A full description of Radesyge. 
Norsk mag. f. Laeger, Vol. IX., 1844, p. 97. 

2) Epidemic of famiry-syphilis ; in one da} 7- H's clinic was visited by 21 
syphilitics, who were members of six families. 

Hock, J. 

Wiener Klinik, 1876, II., Heft 3-4, p. 65-118, 

Statement by Boeck : among 2344 cases of syphilis there was only one 
case of chancre of the eyelid. 
Hoffman, F. Halle. Univ. Prof, of Medicine. 

" Medicinae Rationalis Systematica?." t. IV., 1739, P- I 73- 

1) Boy of 12 years, with recent syphilis, probably chancre of nose, from 
a man-servant with recent syphilis. 

2) A whole family infected from a nurse. 
Holl, J. S. Halle. (See Stahl, G. E.). 

Holm, N. Copenhagen. General Hospital. (Service of Dr. Englested). 
" On the course of temperature in syphilitic children." Hosp. Tidende, 
2, R. VII. , 2, 3, 1880 (Viertelj. f. Derm. u. Syph., 1881, p. 148). 
Eight cases of acquired syphilis in infants. 
Holmes, E. L. Chicago. Prof. Diseases Eye and Ear, Rush Med. College. 
Chicago Med. Journ. and Examiner, 1885 p. 296 . 

1) Two cases, chancre of upper eyelid, source of infection not known. 

2) Case, chancre of caruncle, in young physician, mode of infection not 
stated. 

Holsten, G. D. Brooklyn, N. Y. 

Brooklyn Dermatol, and Genito-Urin. Soc. Meeting, April 1, 1892. 
(Monatsh. f. prakt. Derm., Vol. XV., 1892, p. 194). 
Case, chancre, tip of little finger of left hand in a man. 
Holthouse. London. Westminster Hospital. 
Lancet, London, 1S60, L, p. 573. 
Case, chancre of the finger. 
Homolle, G. Paris. Hop. St. Louis. 

"Syphilis." Nouveau Diet, de Med. et Chirurg. prat. 1883. 
Inoculation of syphilis by opening furuncle — by excising vegetations. 
Names and references not given (p. 672). 
Horand. Lyons. Chief Surgeon, Antiquaille. 

(Reported by Jullien, Traite des mal.ven., Paris, 1886, p. 586). 
Case, chancre of left upper-eyelid. 

Hornung, J. 

" Cista medica," 1624, p. 423 (see Lammert). 
Epidemic of syphilis from scarification, during 1596-99 .about Altdorf. 
(See Epidemics). 

Horst, G. Ulm. 

'' Observ. Medicinal. Surg." lib. II., "de morb. contag.'' Ulm. 1628, 

(GlRTANNER p. 1 98). 

21 



306 SYPHILIS INSONTIUM 



i) Case, a servant-maid, who slept with the mistress of a man, was 
infected by direct contact or through bedding. 

2) Case, a citizen of Ulm, 1622, was infected at a bathing escablishment, 
by the cup-head or scarificator. 

" Epistol. medicinal" de malitura scarificationis." 

3) Report of epidemic from cupping, seen by Snitzer in 1603. 

4) Report by Widmann, 4 q. v. of epidemic from cupping, in 1624; over 
70 persons infected. 

Horteloup, E. and P. 

Bull, de l'Acad., Paris, 1877-8; 1879, V., p. 64-88. (Ann. d'hyg. pub. et 
de med. leg., Paris, 1877. XL VIII., p. 126-151). 
Case, nurse infected by nursling. 
Horteloup, P. Paris. Hop. du Midi. 

La France med., Paris, 1881, II., pp. 133,. 146, 157. (See Leprovost). 

1) Case, chancre of inner angle of eyelid. 

2) Case, chancre of left cheek, from bite. (Simonet). 

3) Case, chancre of left thumb. 

4) Infection of 3-year-old child by using brush of his father (quoted 
from " an American Journal," no reference). 

(See also cases cited by Gibier, Jullien, and Viguier). 
Houghton, J. H. 

British Med. Journ., London, 1866, p. 223. 

Case, syphilis after vaccination in a child 4 months old. 
Howard, J. London. 

"Practical Observ. on the nat. hist, and the cure of the ven. disease," 
London, 1806. Vol. I., p. 156. 
Case, chancre of the hand in a medical man, from necropsy (on the 
penis of the deceased body was a chancrous excoriation). 
Hubbard, G. H. Late Brev't-Col. and Surg., U. S. Army. 
Med. and Surg. Reporter, Phila. , 1866, XIV., p. 103. 

Epidemic of vaccinal syphilis; more than 500 soldiers infected. (See 
Epidemics). 
Hiibner. Frienfels. 

" Erfahrungen uber Vaccine an syphilitisch Krankens mit Rucksicht auf 
die Angelegenheit des Gerichtarztes," Wien, 1855. Nouveau Diet, 
de med. et de chir. prat., Paris, 1883, Vol. XXXIV., p. 673 (Gaz. 
hebdom., 1855, May 9, p. 176). 
Epidemic of vaccino syphilis : 13 children were vaccinated in 1852, of them 8 
were infected, and from these their nurses and mothers ; two mothers 
had chancres of left forearm from contact; several nurses acquired 
chancres of the breast ; an old servant, chancre of the face ; from one 
of the non-infected children 25 more were vaccinated and only one 
became infected. Dr. H. was tried in court and was sentenced to 
prison for six weeks — the first trial in court of a physician for vaccino- 
syphilis. (See Escherich, Heine, Heyfelder, and Epidemics). 

Hue, A. Paris. 

La France med., 1883 (p. 752). (Annales de Derm, et de Syph., 18S4, pp. 

55-57)- 
Case, chancre of right tonsil in a man (service of Pean). 

Hiiebener, E. A. L. 

1) De morbi dithmarsici natura de indole. Dissert. Inaug., Kilise, 1S21. 

2) Erkenntniss und Cur der soganannten Dithmarsischen Krankheit, 
Altona, 1835. 

Hufeland, C. W. Berlin. Univ. Prof, of Medicine. 

"Art of prolonging life," London, 1797 (from the original " Makrobiotik," 
1796. Rust, Helkologie Berlin, 1S42, p. 246). 
Case, syphilis acquired from a tobacco-pipe (Vol. II., p. 103, note). 



ANALYTICAL BIBLIOGRAPHY 3°7 

Huguier, P. Ch. Paris. Hop. de Lourcine. 

"Lecons sur les malad. vener. chez la femme" (Behrend's Syphilidologie 
Bd. V., p. 590). 

1) Case of bilateral chancre of ocular conjunctiva. 

Discussion of Soc. de Chirurg. de Paris, Bulletin de la Soc, 1844. (Cited 
in Behrend's Archiv f. Syph. u. Hautkr. B. I., 1846, p. 157). 

2) Two cases of infection of little girls at pudenda, from use of infected 
sponges. 

Hulke. London. Middlesex Hospital. 

Med. Times andGaz., London, 1875, II., Oct. 21, p. 462* 
Case, chancre of lower lip. 
Hulot, A. Paris. 

Annales de Derm, et de Syph., 1879, p. 29. 

Notes of 19 cases of extra-genital chancre, seen in Fourxier's clinic in 
1877: chancre of tonsil, 3; nose, 3; neck, 3; finger, 2; cheek, 1; chin, 
1 ; eyelid, 1 ; gum 1 ; external ear, 1 ; breast, 1 ; abdomen. 1 ; over 
trochanter major, 1. 
Hiinefeld, L. 

Die Radesyge oder das scandinavische Syphiloid, Leipzig, 1828. 
Contains a full bibliography of the subject. 

Hunter, J. London. St. George's Hospital. 

" Treatise on the Venereal Disease," with Adams' Commentary; American 
edit., Phila., 1S1S. 

1) Case, chancre of lip (prolabium) in a man, "probably from auto- 
infection by the fingers " (p. 199). 

2) Case, chancre of breast, nurse from nursling (p. 357). 

3) Case, nurse infected by child of last case (p. 358). 

4) Two nurses and two children infected from one syphilitic child (p. 359). 

5) Two cases of infection from transplanting teeth (p. 361). 

Hutchinson, J. London. Surgeon to London and Royal London Ophthal. Hosp. 
Med. Times and Gaz. , London, 1S56, Oct. 11, pp. 366-71. 

1) Fifty cases of infection from the foetus to the mother. 
Lancet, London, 1S62, II.. p. 327. 

2) Case, chancre of right thumb, in a midwife. 
Med. Times and Gaz., London, 1871, II., p. 705. 

3) Case, chancre of right knuckle, in a policeman, by fighting. 
Transact. Royal Med. and Chir. Soc, London. Vol. IV., 1871. 

4) 19 cases, ten chancres and nine infections after vaccination (pp. 2, 16). 
Med. Times and Gaz., London, 1872, II., p. 515. 

5) Case, chancre of finger, in a man 31 years old. 
Med. Times and Gaz., London, 1S72, I., p. 432. 

6) Case, chancre of right upper eyelid, in a man 27 years old. 

Med. Times and Gaz., London, Nov., 1872 (Amer. Journ. of Syph. and 
Dermat. Vol. IV., 1S73, p. 165). 

7) Case, chancre of the finger, from using a towel. 

Med. Times and Gaz., London, 1873, I., p. 126 (also Lancet, 1S73, I., 
pp. 1 09, 175). 

8) Two cases, chancre and inlection after vaccination. 
Med. Times and Gaz., London, 1877, I., p. 307. 

9) Case, chancre of the tongue, in a woman. 
"Illustrations of Clinical Surgery," Fascic. VI., London, 1877. 

A masterly presentation of the subject of Vaccinal-Syphilis, reviewing 
six series of personal cases, with four plates illustrating vaccination 
chancres. 

10) First series; twelve vaccinated, ten infected (p. 115). 

11) Second series; many vaccinated, nine infected, suspicious symptoms 
in six others (under care of Mr. Waren Tay, q. v.) (p. 122). 

12) Third series; several vaccinated, one infected; man aged 46 (p. 125). 



308 SYPHILIS INSONTIUM 

13) Fourth series; three vaccinated, one infected, woman aged 46 (p. 126). 

14) Fifth series ; two infants infected, one of them infects its mother at 
nipple, and she her husband on penis (p. 128). 

15) Sixth series; one case, a lady, vaccinated in India (p. 129). 
Lancet, London, 1879, I., p. 619. 

16) Case, chancre of tipper lip. 
"Syphilis." London, 1887. 

17) Eight cases, chancre of the finger (pp. 96, 132, 134, 386, 473). 

18) Three cases, chancre of nipple (pp. 101, 118, 120) (Lees' Case). 

19) Three cases, chancre of the tongue (p. 101 ; plate 112). 

20) Two cases, chancre of the tonsil (p. 101). 

21) Two cases, chancre of the lip (pp. 152, 468). 

22) About 26 cases, infection after vaccination (pp. 104, 107, 109) (Case 
of Dr. C). 

23) Seven cases, infection after circumcision (p. ii5)(Macnamara's Case). 

24) Three cases, infection in lying-in women, by physician or midwife 
(pp. 101, 105). 

25) Two cases, chancre of ocular conjunctiva (p. 101). 

26) Case, chancre of palm of hand (p. 101). 

27) Case, chancre middle of sole of foot (p. 101). 

28) Two cases, infection, policemen from injuries (p. 102). 

29) Case, chancre in several places, in a sailor, from bites (p. 102). 

30) Case, chancre on one labium, child one year old (p. 118). 

31) Case, chancre on one of the nates (p. 134). 

32) Case, chancre of tonsil in man from feeding-bottle (p. 382). 
British Med. Journ., 1888, II., p. 1199. 

33) Case, chancre of the knuckle. 
Archiv. of Surgery, 1890, Vol. I., p. 53. 

34) Case, chancre of the lip, in a man 30 years of age. 
Archiv. of Surgery, 1891, Vol. II., p. 170-237. 

35) Two cases chancre of the finger. 
Archiv. of Surgery, 1892, Vol. III., p. 252. 

36) Case, chancre of cheek, a little external to the left commissure of tne 
lips. Mode of infection, sex, and age of patient not given. 

Hutchinson, Jonathan, Jr. London. 

International Med. Annual, 10th year, 1892, p. 481., 

1) Case, chancre of occiput. 

2) Case, chancre of heel. (Infection in both by means of dressings to 
small wounds). 

Hutin, J. M. Felix. Paris. Hotel des Invalids. 

"Recherches sur les tatouages," Paris, 1853 (p. 10). (Les Comptes rendus 
de i'Academ. de med. t. XVIII., p. 349). 
Case, soldier inoculated by tattooer with primary syphilis, at Hop. Val 
de Grace, 1823. 
Hyde, Jas. Nevins. Chicago, U. S. A. 

Chicago Med. Journ. and Exam., 1878, XXXVII., p. 457, 

Case, chancre, radial border of right thumb in 14-year-old nurse from 
nursling. 
Idelson, I. S. Krytchev, Russia. 

Annual of Med. Sci., 1888, Vol. II., p. 454. 

1) Case of Vvedenski, q. v. 1 , three chancres of left fore-finger. 
Vratsch, 1891, No. 14, p. 374 (St. Louis Med. and Surg. Journ., June, 1S91, 

p. 365)- . • 

2) Case, chancre of the chin, acquired in a barber shop. 

Ilisch, J. J. 

"Die gewohnlichen Krankh. des menschl. Korpers, mit besond. Beziehung 
auf die Landbewohner der Ostseeprovinzen u. d. russ. Reiches." 
Dorpat u. Riga, 1S22* (HOnefeld "Radesyge etc.," 1S2S). 
Study of Russian "Syphiloid " 



ANALYTICAL BIBLIOGRAPHY 309 

Inell. 

Three cases, chancre of the tonsil (see Malm 2 ). 
Jacquet, B. Laibach. Univ. Prof, of Surgery. 

Nov. Act. . . . Acad. 'Nat Cur., VI., Norimb., 1778. (Obs. 64, p. 302). 

(GlRTANXER, No. 1 556). 

Case, nurse infected by nursling. • 

Jadassohn. 

Verhandl. der Schlesischen Gesellsch. f. Vaterland. Cultur, 1890. Archiv 
f. Derm. u. Syph., Vol. 23, 1891, p. 788. 
Case, chancre of tonsil, in 2S-year-old patient, source unknown. 
Jaffe, J. Leipzig. 

" Die rituelle Circumcision." . . . Leipzig, 1886. 
Circumcision inoculation: cases of Brecker, Vanter, von Pitha, Solo- 
mon, Segel, Fischer, and Obalinski (p. 31-32). 
Jakinovitch, N. N. St. Petersburg. 

Vratsch, 1891, No. 1, p. 21 (Joarn. of Laryngology, July, 1891, p. 279). 
Case, chancre of the left tonsil, in man 22 years old, source unknown. 
Jakoleff, S. S. 

Verhandl. der russ. syph. -derm. Gesellsch., St. Petersburg. Vratsch, 
1S90, No. 18, p. 426 (Monatsh. f. prakt. Derm. 1S90, Vol. XL, p. 69). 

1) Case, chancre of lower lip, in 14-year-old girl, from kissing. 
Verhandl. der russ. syph. -derm. Gesellsch., St. Petersburg, Sitz., Apr. 

27, 1 891. Vratsch, 1891, No. 18 (Monatsh f. prakt. Derm. 1S91, Vol. 
XIII. , p. 48). 

2) Case, chancre, left corner of mouth, in 3S-year-old woman, probably 
from a cigarette. 

3) Case, chancre, right corner of mouth, in 21-year-old man. 
Jarotsky, A. I. Tikhvin, North Russia. 

Vratsch, 1892, No. 4, p. 74. 

1) Statistics; among 2540 miscellaneous cases in 5 rural districts, (total 
inhabitants 9S79) 1.47 percent were syphilitic, mainly from family life. 

2) Small family epidemic of syphilis, introduced by dry-nurses. 

3) Cases, laborer infects S of a family, innocently. 

Jegu, G. Paris. 

" De la syphilis de l'oreille," These de Paris, 1S84. 
Case, chancre of the ear. (See Lavergxe and Perrin 2 ). 

Jelzina, S. 

Vratsch, 1882, Nos. 50-52; Vratsch, 18S4, Nos. S-9 (Archiv f. Derm. u. 
Syph., 1889, p. 242). 

1) Among Russian peasantry, the spread of syphilis is generally by 
extra-genital means: thus, of 55 syphilitic women, only 2 were 
infected by coitus 2 from nursing, 45 from family life, and 2 
hereditarily. 

Russian dermat. and syph. Soc. Jan. 2S, 1889 (Archiv f. Derm. u. Syph., 
1889, p. 243). 

2) Case, chancre of finger, in a 13-months-old child. 

Jenkins, J. O. Newport, Ky. U. S. A. 
Phila. Med. News, Aug. 30, 1.S87. 

Case of vaccino-syphilis, vaccination with barber's razor. 

Jenniker. 

Geschichtlich. administrativer Ilauptbericht liber die Skerljevo Heilan- 
staltcn zu Fiume trad Portorc. Med. Jahrbuchern des Osterr. Kaiser- 
staates, 1S19, 1820, Bd. V., 2 St.* 

Johnson, G. Cambridge, England. 
British Med. Jour., Aug., i860. 

1) Case, chancre of nipple, in woman from kiss by lover (p. 649). 



3IO SYPHILIS INSONTIUM 

2) Case, nurse infected by syphilitic infant, case before civil tribunal in 
France (p. 713). 
Joly, L. Brussels. 

Journ. de med. de chir. et de pharm. de Bruxelles, 1853, p. 92. 

Epidemic of syphilis at Alsembourg, 1853. Notes of individual cases 
by Seutin, including the case of the breast-drawer, a ten-year-old 
boy, with chancre of the tonsil, from his mother's nipple, she having 
been infected by a nursling. (See Epidemics). 
Jones, J. Nashville, Tenn. Prof, of Phys. and Path. Univ. of Nashville. 
"Researches on Spurious Vaccination," 1867 (Nashville Journ. of Med. 
and Surg., New Ser., Vol. II., 1867, pp. 1, 81, 161). 
Three epidemics of vaccino-syphilis, occurring among soldiers of the 
Confederate armies. Also account of epidemics observed by Perci- 
val and Hubbard. (See Epidemics). 

Jones, S. London. St. Thomas Hospital. 
Brit. Med. Journ., March 1872, I., p. 313. 

Case, chancre of left hand, from a bite in a man of 42 years. 

Jordanus, T. Brunn. Archiater of the Province. 

" Brunno-Gallicus seu Luis novse exortus, etc.," 1578 (cited in Grun- 
er's "De Morbo Gallico Scriptores," pp. 496-582). 
Epidemic at Brunn, Moravia, 1577, from cupping, described in the year 
following the outbreak, (See Epidemics). 

Josias, A. French Military. (Service of Simonet). 
Progres Medicale, 1877, p. 205. 

Epidemic from tattooing, nine soldiers inoculated by a syphilitic tat- 
tooer. (See Epidemics). 

Juler, H. E. London. Ophthalmologist, St. Mary's Hosp. and Royal West- 
minster Ophthalmic Hosp. 
Two cases, chancre of conjunctiva, in young women (see De Beck 3 ). 

Jullien, L. Paris. 

"Traite des malad. vener." 2d ed., Paris, 1886. 

1) Statement: He has "seen more than one grand-mother victim of her 
affection for her grand-child." 

2) Case, woman infected from a syringe of a syphilitic friend (p. 506). 

3) Case, chancre of neck, from bed clothing. 

4) Cases of Diday's, unpublished: 

a) Two cases of anal chancre in infants from towels or napkins, etc. 

(P- 507). . . 

b) Case of infection, by a kitchen spoon, which is parallel with 
Rollet's case (p. 507). 

5) Cases of chancre of external ear; Jullien saw "two or three " at the 
Antiquaille. 

6) Case, chancre of tonsil, service of Verneuil, in an old woman from 
drinking-glass (p. 583 — woodcut). 

7) Case or cases of Gosselin, from Eustachian infection (p. 506). 

8) Case of Horteloup's, phagedenic chancre of tongue (p. 581). 

9) Case of Hillairet, chancre of nose (p, 584). 

10) Case of Lailler, chancre, septum nasi (p. 585). 

11) Case, chancre of back of reck, from clothing (p. 507). 

12) Case of P. Pellizzari's (unpublished) chancre of breast in mother 
from own child (exception to Colles' law) (p. 10S6). 

13) Case, chancre, finger, in physician, contact with chancre of scrotum 

(p. 537)- 
Cited in Tillmann's Lehrbuch der allgem. Chirurg. , Leipzig, iSSS, 
(Archiv f. Derm. u. Syph., 1890, p. 501). 

14) Proportion of extra-genital chancre, 5 to 6 per cent, in men and 25 to 
26 per cent, in women. 



ANALYTICAL BIBLIOGRAPHY 311 

Jumon. L. Paris. 

" Etude sur la syphilis ignoree." These de Paris, 1880. 

1) Case of Fournier's, young woman, chancre, calf of leg, in site of 
wound which was sucked by a youth (p. 26). 

2) Case of Bassereau's, chancre in site of wound made in excising 
gonorrhoeal vegetations. 

3) Case of Fournier's, chancre of hand in a physician. 

4) Case of Fournier's, infection per os of a medical man, by paper- 
knife used previously as tongue depressor on a syphilitic (p. 30). 

5) Case of Fournier's, chancre of anterior femoral region, from holding 
a lightly clad woman in lap. 

Junquet. Montpellier. 

Gaz. med. de Montpellier, Aug., 1859. 

1) Two nurses infected by nurslings 

2) One of these infects her mothei in-law. 

3) The other nurse infects her husband and child. 

Kaposi, M. Vienna, Royal Imperial Gen. Hosp. Div. for Skin Diseases. 
"Syphilis der Schleimhaut," Wien, 1866. 

1) Case chancre of lower lip in a girl, from bite of lover (p. 63). 
Syphilis der Haut und d. angranz. Schleimhaiite, Atlas, Wien, 1873. 

2) Two cases, chancre of penis in Jewish infants from circumcision. 

3) Case, chancre of finger in hospital attendant. 

4) Case, chancre of chin from a bite. (Both latter in Zeissl's Atlas, 1875). 

5) Two cases, chancre of tongue, in old woman, and young girl, source 
unknown. 

"Pathol, und Therap. der Syph.," Stuttgart, 1SS1. 

6) Case, chancre of the hairy scalp (p. 61). 

7) Case, chancre of left cheek, in an old man (p. 62). 
Archiv f. Derm. u. Sj-ph., Vol. XXIV., 1892, p. 842. 

8) Case, chancre of lower lip in a man, cause not given. 
Kapustin. 

Arbeit des 2 te Gouv. Congr. der Kursk' Landsch., Lief I., Kursk, 1884. 
Cited by Herzenstein, "Syph. in Russland" (Archiv f. Derm. u. Syph., 
1881, p. 243). 
Largest percentage of extra-genital syphilis is in children from one to ten 
years of age, or 23 per cent. 
Karamanenko, S. Odessa, 

Zemsk. Med. Khersonskoi Guberni, 1888, p. 251. 

1) Four women infected through nursing ; one infected own child. 

2) Peasant, married man, aged 24, infected by fellow-laborer during 
field work; he shortly infected his father aged 60, brother aged 11 
and three sisters aged, 18, 16 and 6. 

3) Above little girl, aged 6, infected a neighbor's child during play. 

4) Peasant woman and her two children infected by neighbor's child. 
Kaverin, V. Uijni. Korotchan, Voronej Gov., Russia. 

"Concerning public prophylax. of Syph." Meditz. Beseda, 1887, No. 9 
(p. 219). 

1) Nurse infected two children. 

2) Nurse infected one child. 

3) A cook infected two children, the latter transmitted the disease to its 
father and mother. 

KedotoffA. Cronstadt. Phys. impcr., Russian Marine. 
Annates de Derm, et de Syph., Paris, 1884, p. 526, 

Small epidemic of circumcision syphilis; three infants infected, each 
communicates disease to mother by lactation, 
Kehrer, F. A. 

Prakt. Arzt., Wetzlar, 1883, XXIV., p. 49. 
Infection of nipple. 



312 SYPHILIS INSONTIUM 

Kemme, Johannes Christlieb, and Milloradovics, Petrus Gabrielow. 

" Dissertation inaug. de innocenti infectione venerea. Hake Magdeburgi- 
cae, 1767 (p. 24).* 
Kenny. Melbourne. 

Australasian Med. Journ., 1889, XL, No. 9, p. 428, 
Case, chancre on under surface of the tongue. 
Kessler. Dorpat. Univ. Prof, of Midwifery. 

Vratsch, No. 34, 1883, (p. 540) (Canstatt Jahrbuch). 
Case of circumcision syphilis, infant aged 28 days. 
Keyes, E. L. New York. Surgeon to Charity Hospital. 

"A practical treatise on and Syphilis." (Van Buren and Keyes), 

N. Y., 1874. 

1) Case, chancre of right arm from carrying syphilitic infant (p. 514). 

2) Case, chancre of lip, from kissing fiancee (p. 522). 

3) Case, chancre of upper lip, from tobacco-pipe (p. 523). 
Archives of Dermatology, 1878, p. 126. 

4) Case, multiple chancre of breasts, from nursling. 

"The Venereal Diseases." New York (Wood's Library, 1880). 

5) Two cases, chancre of lip from kissing (p. 88). 

6) Case, chancre of lip, from tobacco-pipe (p. 88) (same as above?). 
Journal of Cutan. and Ven. Dis., New York, 1886, p. 22. 

7) Case, syphilis accidentally acquired. 
Kilian. Bonn. Univ. Prof, of Obstetrics. 

(Published by Ruthenburg, q. v.). 

1) Case, nursling, chancre of eyelid and lip, source unknown unless 
from dry-nurse. 

2) Case, nursling infected through dry-nurse, who chewed its food. 

3) Case, nurse from preceding nursling, by lactation. 

Kinsman, D. N. 

Cleveland Med. Gaz., 1S85-6, I., 494. 
Case, chancre of gum. 
Kirkpatrick, Robt. C. Montreal, Canada. Asst. Surgeon, Montreal Gen. 
Hosp. 
New York Med. Journ., Vol. LVL, No. 27, p. 745. 

Case, chancre left side lower lip, in married man of 42 years, from a 
cigar made by a syphilitic. 
Klein. Andernach. 

(Reported by Ruthenburg, q. v., Obs. iv.). 

1) Epidemic at Andernach, 1816-17, beginning as vaccino-syphilis, and 
continued through domestic infection. (See Epidemics). 

" Die rituelle Circumcision, eine sanitats Frage " Allgem. Med. Central 
Zeit'g, Berlin, 1853, No. 39, p. 311. 

2) Mention of several cases, infection after circumcision. 

Kleiner, M. 

New York Med. Record, Vol. XL., 1891, p. 302. 

Case, chancre of lip, from applying to chapped lip vaseline used upon a 
chancre. 
Klink, E. Warsaw, Poland. 
Gazet lecarska, 1880, No. 1. 

Statistics: combined figures of hard and soft primary sores, total 2846; 
breast 24, fingers 4, nose 2, " head " 2, tongue 1, foot 1. 
Klotz, H. G. New York. 

Journal of Cutan. and Genito-Urin. Diseases, N. Y., 1891, p. 29S. 

Case, chancre, front aspect of the lower third of left thigh, in 28-year-old 
patient, source unknown. 

Kluge, C. A. F. Berlin. Surgeon-in-Chief and Director of Charite Hospital. 
(Quoted by Behrend in " Syphihdologie," Bd. IV., 1S43, p. 325). 



ANALYTICAL BIBLIOGRAPHY 313 

Statement: Kluge believed that cigar-makers infected the cigars not by- 
saliva, but by hands soiled with secretions. (Xo individual cases 
cited). 
Knapp, H. New York. Prof, of Ophthal., Coll. of Phys. and Surgeons. 
De Beck, q. v. "Hard chancre of the eyelids," etc., 1S86. 
Cases, chancre of the eyelids. (Xo notes given). 
Knight, C. H. Xew York. 

Xew York Med. Journal, 1SS4, XXXIX., p. 662. 

1) Case, chancre of tonsil, in a woman, from using same dentrifice with 
her syphilitic nephew. 

2) Case, chancre left tonsil (Bumstead). 

K5bner, H. Breslau. Univ. Clinic for Skin Dis. and Syphilis. 

"Klin.u. experiment. Mittheil. ausder Dermatol, u. Syph.," Erlangen, 1864. 
(Reprint of articles in Deutsch Klinik, 1S62, 1S63). 

1) Case, chancre, back wall of pharynx ; from spoon-feeding her infant 
nephew (p. 54). 

2) Case, infection per os of a 6-year-old boy, whose mother was suffer- 
ing from a relapse of former syphilis (p. 58). 

3) Case, acquired syphilis in a 2^ -year-old child, from bathing in water 
used by syphilitic father with intertrigo (mucous patches) of toes 
(P- 53). 

4) Case, infant of 1 year, infected by mother's kisses (p. 61). 

5) Case, the above infant infected its grand-mother through bottle- 
feeding. 

6) Case, infant infected by its foster-mother, method not stated (p. 61). 

7) Case, chancre of arch of palate, infected by her grand-child (p. 61). 

8) Family epidemic of syphilis, occasion of suit for damages (p. 63). 

9) Case, chancre of finger m a midwife from professional exposure 

10) Case, patient infected by opening axillary boil with soiled lancet 
(p. 65). 

11) Case, patient infected by scarifying scrotum for epididymitis with 
soiled instrument (p. 65). 

Archiv f. Derm. u. Syph. III., 1871, pp. 133, 507. 

12) Case of vaccino-syphilis, in a young physician (p. 139). 

13) Case of vaccino-syphilis, child 2 years old, died 6 months later 

(P- U4). 

14) Table of principal epidemics of vaccinal-syphilis (p. 159). 

Kobylin, W. A. St. Petersburg. Kalinkin Hosp. 

(Cited by Petersen, monatsh. f. prakt. Dermat. 1SS8, p. 309). 

Six cases, chancre of the breast, among 77 cases of recent syphilis seen 
during 1S80. 
Kocevar. District-Physician of Cilli, in Styria, Austria. 

"Zur Impfgeschichte vom S. Marien." Ann. Rep. for 1S69, Allg. "Wien. 
Med. Zeit'g, 1870, No. 21 (p. 266) (Yiertelj. f. Derm. u. Syph. II., 

P- 453). 
Epidemic of vaccino-syphilis in two parishes, remarkable for the num- 
ber and variety of infections: 31 infants infected, from these 19 mothers 
and 11 other children were in turn infected. (See Epidemics). 
Koch. 

Wiener med. Blatter, 1SS7, Xo. 52, (p. 1644) (Archiv f. Derm. u. Syph., 
1888, p. 838). 
Case, chancre of finger in site of wound made by a drawing-instrument, 
probably infected by the saliva of some unknown person. 
Kogan, E. A. St. Petersburg!-). 
Vratsch, Xo. 40, 1-90, p. 925. 

Case, chancre of upper lip, in a woman from drinking-glass. 
Kohn, Moritz. (Sec Kaposi). 



314 SYPHILIS INSONTIUM 



Kolokolow, W. 

Meditsinskoe Obosr., Moskow, 1888, XXIX., p. 700. 
Two cases, of chancre of the lip, domestic infection. 
Kolomensky, A. Moscow. 

Proto. d. Gesell. Russ. Aerzte, 188S (Archiv f. Derm. u. Syph. 1889, p. 

243). 
Case, chancre of this tongue. 

Koltschewski, K. 

Vratsch, 188?, No 45 (Canstatt Jahresbericht for 1883). 
Case, chancre of the chin, in site of razor- cut. 
Komin. 

Trans, of the 2d St. Petersburg Gov. Sanitary Meeting, 1877, pp. 123-140. 

1) Case, chancre near left nipple, nurse from nursling (from a "home"). 

2) Case, chancre right areola, nurse from nursling, infecting her own 
boy of 5 years. 

3) Two peasant girls aged 12 and 7 years, infected per os, from hand- 
feeding a syphilitic infant. 

Kopp, C. Breslau. (Prof. Neisser's Clinic). 

Archiv f. Dermatol, u. Syph., 1885, pp. 55, 183. 

1) Statistics: of 125 cases of recent syphilis, treated by the hypodermic 
method, four males are mentioned, as having chancre of the lip. 

2) Case, child 3 years old, infected by its mother. 
Kopp, J. H. Frankfurt-am-Main. 

" Aerztliche Bemerkungen veranlasst durch eine Reise in Frankreich und 
Deutschland." Frankfurt, 1S25 (Froriep's Notizen, Weimar, 1825, 
No. 243). 
Case or cases of infection of midwives. 
Kortiim, C. G. T. Stolberg. 

" Beitrage zur prakt. Arzneiwissensch.," Gottingen, 1795, p. 336. 

1) Case, chancre of the lip. 

Hufeland's Journal, Berlin, XX., 1805, St. III., p. 31. 

2) Case, nurse infected by nursling. 
Korver, J. M. 

Akadem. Proefschrift, Amsterdam, 1880, p. 80.* 
Vaccinal-syphilis. 
Kosinski, J. Warsaw. University Prof, of Surgery. 
Congress of German Surgeons, 1867. 

Cases of circumcision-syphilis. (See Bierkowski, and Nowakowski). 
Kotzyn, I. B. Kovno, Russia. 

Russkaya Meditsina, 1890, No. XXV., p. 391. 
Case, chancre in a circumcision wound in a child 10 weeks old. (The 
man who performed the operation was healthy, but it was supposed 
that the virus was carried on his instruments, which were seldom 
cleaned). 
Krelling, M. Leipzig. Prof. Lesser' s Univ. Clin, for Skin and Yen. Dis. 
Archiv f. Derm. u. Syph., Wien., 1888, p. 9. 

1) Case, chancre of the eyelid in a youth from a public woman. 

2) Case, chancre on ala of nose, in a woman of 35, from a woman with 
mucous patches, who applied her saliva to heal an erysipelas. 

Kreundel. St. Petersburg. 

Verhand. der russ. syph. -derm. Gesell. in St. Petersburg, Sitz., Apr. 6, 
1 89 1. (Monatsh. f. prakt. Derm., Vol. XIII., 1S91, p. 17). 
Case, chancre of upper lip in a soldier from a cigarette. 
Krishaber. Paris. 

" Conferences cliniques sur les maladies du larynx," 1877 (Annales des mal. 
de l'Oreille, 1877). 
Case, chancre of the epiglottis (p. 121). 



ANALYTICAL BIBLIOGRAPHY 315 

Krowczynski, J. Lemberg and Cracow. 

Przeglad lekarski, 1S77 (Virchow-Hirsch Jahresb., 1877, Bd. II., p. 528). 

1) Case, chancre of palate from a spoon. 
Przeglad lekarski, 1887. 

2) Case, a man aged 64, infected in infancy. 
Kiidriashoff. St. Petersburg. 

Vratsch, 1892, No. 31, p. 783. (Journ. des mal. cut. et syph., Vol. IV., 
Oct., 1892, p. 577). 
Case, chancre of penis in boy 2 years and 10 months old, probably 
infected from its nurse's mouth, the latter being syphilitic. 
Kiihn. Philadelphia. U. S. A. 

Case, inoculation from tooth implantation. (See Lettsom 3 ). 

Kyll, J. B. 

"Ueber syphilitische Ansteckungen von Wochnerinnen durch Milchsauger- 
innen." Zeitschr. f. d. Stattsarzneikunde v. A. Henke, Erlangen, 
1837, Heft 2.* 
Syphilitic infection of lying-in women by breast-drawers. 
Labbe. Paris. Hop. de la Pitie. 

(Reported 1872 by Ory, q. v. 13 , notes by Coyne, interne). 
Case, chancre of upper lip, in a man or 52 years. 
Laboulbeae, A. Paris. Charite Hospital. 
L'Union med., 1S65, p. 191. 

1) Case, Eustachian infection, in an aged clergyman. 

2) Case, chancre of the tonsil. (See Le Gendre -). 
Lacheze. 

L'Union med., Paris, 1862, No. 112, p. 576. 

Epidemic from vaccination ; two children and their families. 
Lacroze. Paris. 

(Notes furnished Fournier for his study on cephalic chancre, 1858). 
Case, chancre of the lip. 
Ladreit-de-Lacharriere. Paris. 

"Des paralysies syphilitiques," These de Paris, 1861. 
Case, chancre of the chin (p. 22). 

Ladroire-Yver, E. Paris. 
These de Paris, 1S54. 

Case, chancre of cheek in razor-cut ; officer from camp-barber, following 
pressure with finger to check hemorrhage. 

Lagneau, G. (fils). 

Annales d'hyg. publ. et demed. leg., Paris, 1855, 2d Ser., Vol. V., pp. 21, 
68, 241, 298. 

1) Case, nursling infects nurse, she her own child. 

" Malad. syphil. du system nerveux," Paris, i860, p. 508. 

2) Case of Hourmann, infected either from a necropsy, or examination 
of a prostitute (Lagneau, Sr., took notes at the time; the same case 
also given by Cazenave, Vidal and others). 

Bullet, de la Soc. de med. legale, Seance April 5, 1875 (Annales d'hyg. 
publ. et de med. leg., 1875, XLIV., p. 161). 

3) Case of Defaucambourge of Gien, nursling infects nurse. 
Revue d'hyg. et de police sanitaire, 1879, p. 301. 

4) Case, infection of a young girl, from spoon-feeding a foster-infant. 

Lagneau, L. V. Paris. Hop. des Veneriens. 

" Traite prat, des mal. syph.," 6th Edit., Paris, 1828. 
Two cases, chancre of the throat (pp. 49, 51). 

Lagrange, (father and son). Chalous. 

(Reported by Viennois, 1863; also Guixaxd, 1881). 

Several cases of syphilis from glass-blowing ; a family epidemic added. 



3 l6 SYPHILIS INSONTIUM 

Lailler, C. Paris. Hop. St. Louis. 

L'Union medicale, XXIV., 1864, No. 120, 129. 

1) Case, woman of 47 years, chancre apparently both at nostril and in 
throat. 

(Cited by Jullien, " Traite prat, des mal. ven," Paris, 1886, p. 498). 

2) Case, multiple chancre penis and scrotum, acquired while under 
treatment for scabies. 

(For other cases see Guignar 7 , and Ory). 
Lallemand, C. F. Montpellier. Univ. Prof . of Clinical Surgery. 
Journ. universelle. . . . XXVIL, p. 132. 

1) Two nurses infected by the same nursling. (See also Legrand, Obs. 

344, 345, 346). 

2) Case reported by Souchier, q. v., multiple chancre breast, nurse 
from nursling. (Cited by Legrand). 

Clinique med.-chirurg. de Montpellier, 1845, p. 15. 

3) Mentions having seen a dozen cases of cephalic chancre. 

4) Chancre of the lip in three youths from same woman, by kissing. 
Lammert. 

Virch. Archiv., XXIV., 1S62, p. 297. 

1) Epidemics from cupping, at Niirnberg, 1599 (unpublished); also sev- 
eral others of that epoch, published at the time. (See Hornung). 

2) Edict in 1C61, of Duke George Frederick, against syphilitics mingling 
at weddings, feasts, bath-houses, etc., and also against syphilitic chil- 
dren being nursed by healthy persons, or being allowed in school, etc, 

Lancereaux, E. Paris. Hop. de la Pitie. 

"Traite historique et pratique de la syphilis." Sydenham Society Edit., 
London, 1869. 

1) Case, of Raynaud's 1863, Eustachian infection. (Vol. II., p. 244). 

2) Case of infection from a tobacco-pipe (Vol. II., p. 246). 

id) Case of Vercelloni, chancre of hand from contact with genitals. 
(Vol. II., p. 233). 

3) Case, child 6 years old, infected by nurse, infects its mother. (Vol. I., 
p. 94). 

4) Case of Rayer's, a young virgin with recent syphilis; her room-mate 
was syphilitic. (Vol. II., p. 232). 

4«) Epidemic vaccino syphilis, 8 out of 13 infected. (See Hubner and See). 

5) Case, chancre of the uvula; no details. 

5<z) A study of Sibbens, Yaws, Radesyge, Amboyne Pimple, Disease of 
St. Paul's Ba}r, Sherlievo, etc. 
" Traite histor. et prat, de la syphilis," 2d edit., Paris, 1873, p. 493. 

Collected statistics of vaccinal-syphilis. 
L'Union med., 1886, No. 40, p. 469. (Reported by Besancon). 

6) Case, Eustachian infection in male 53 years old. 

Bullet, de l'Acad. de med., 1889, XXII., p. 447. (L'Union med., 18S9, 
XLVIIL, p. 655). 

7) Case, Eustachian-sound inoculation, in man 55 years old. 

8) Case, chancre of the gum, by dental operation, in 36-year-old woman 

Landolt. See Wecker. 

Lang, E. Innsbruck. Univ. Clinic, Skin and Venereal Diseases. 
Archiv f. Derm. u. Syph., 1878, p. 535. 

1) Case, chancre of forehead, from opening a furuncle with an unclean 
lancet. 

Bericht. der syph. derm. Klinik, for 1882. Innsbruck, 1883. 

2) Statistics: of 19 primary lesions, 4 were extra-genital. 

3) Two cases, chancre of upper lip. 

4) Two cases, chancre of lower lip. 

5) Case of vaccino-syphilis (p. 35). 
"Vorlesungen Uber Syphilis," Weisbaden, 1S84-6. 

6) Family epidemic of syphilis (p. 70). 



ANALYTICAL BIBLIOGRAPHY 317 

7) Case, chancre, lower lip from a kissing game (p. 200). 

8) Case, chancre, tonsil, woman of 59 years, from feeding-bottle of 
heredito-sypnilitic child (p. 200). 

9) Case, chancre of thumb (p. 490). 

Wiener derm. Gesell. , Sitz. Apr. 6th, 1892. (Archiv f. Derm. u. Svph., 
Vol. XXIV., 1892, p. 869). 
10) Case, chancre of thumb in a man, auto-inoculation from his penis. 
Langenbeck. Berlin. 

" Nosol. u. Therap. d. chirurg. Krankheiten " Bd. II. (Cited by 
Oesterlen, ''Yen. Contag.," 1836, p. 200). 
Case, infected by fiance, kissing. 
Langenbeck, B. von. Berlin. Charite Hospital. 

Berlin, klin. Wochenschr., 1872, No. 39, p. 474 (Archiv f. Derm. u. Syph., 
1S72, p. 575). 
Two cases of vaccino-syphilis. 
Langlebert, E. Paris. 

Gaz. des Hop., i860, XXXIII., pp. 338, 374. 

1) Case, chancre of right nipple, from sucking. 

" La syphilis dans ses rapports avec le marriage," Paris, 1873. 

2) Cases of^ Campbell, p. 244; Diday, p. 245; and Tardieu, pp. 306, 313, 
" Lettres a Emile," Paris, 1880. 

3) Case, chancre of lip, in a man, from kissing (p. 32). 
11 Traite pratique de la syphilis," Pans, 1888. 

4) Many cases (1-10 of the population), chancre of the upper eyelid, by 
tongue of a syphilitic woman (p. 18) (Tepliaschin, q. v.). 

5) Case, chancre of the lip (p. 58) (personal). 

6) Case, chancre on the neck (p. 62). 
Lanoix, G. Paris. 

Essay on vaccinai-syphilis, New York, 1872, 8° (pp. 6-8). (From La Tri- 
bune Medicale, 1869). 

1) Case, infection of nursling from nurse, producing by vaccination, 

2) Ten other cases (seen by Ricord, and Bouchut). 

Lanz, A. J. Moscow. 

Mittheilung in d. Mosk. med. Gesell., Nov. 15, 1886 (Archiv f. Derm. u. 
Syph., 1889, p. 244). 
Case, chancre of the tongue, from using table-ware in common. 
Lanzonus, J. Ferrara. Prof, of Philosophy and Medicine. 

''Opera omnia" Lausann, 1738, 4to. The book " De saliva " also sepa- 
rately published at Ferrara, 1702 (Girtanner, 645). 
Cited by authors as reporting cases of syphilis insontium. 
Laroyenne, L. Lyons. Antiquaille. Prof, of Gynecology. 

Gaz. med. de Lyon, 1864, No. 16, p. 292. (Viennois " De la syph. vacc," 
1S65, p. 174). . 

1) Case of vaccino-syphilis in girl of 5 months infecting mother, chancre 
left breast. 

Gaz. med. de Lyon, 1865, p. 530. 

2) Three cases, chancre of eyelid, service of Nelaton and Desgranges. 
Lasch, Otto. 

Archiv f. Derm. u. Syph., Vol. XXIII. , 1891, p. 76. 

Case, chancre of chin and lip, in man of 32, from common use of drink- 
ing-glass. 

Laskiewicz, W. J. Charkow. Univ. Prof, of Clinical Medicine. 
Przeglad lekarski, 1877. 

Case, chancre of left lower eyelid, of unknown source. 

Laugier. Yienne. (Isere, France). 

Viennois " De la syph. vaccin.," Paris, 1S65, p. 303. 
Case, chancre of arm, from vaccination lancet. 



318 SYPHILIS INSONTIUM 

Launois, M. Paris. 

Case, chancre of tonsil, service of Duguet. (See Le Gendre 8 ). 

Laurent, E. 

Gaz. med. de Paris, 1887, 7th Ser., IV., p. 605. 

Case, chancre at root of nose, in man 23 years of age. 

Lavergne, F. and Perrin, L. Hop. St. Louis. (Internes). Service of 
Fournier. 
Annales de Derm, et de Syph. , 1884, pp. 332, 380. 

1) Statistics: 27 extra-genital chancres, 21 in males, 6 in females; lips, 10; 
eye and eyelids, 5 ; cheek, 2 ; anus, 2 ; nose, 1 ; ear, 1 ; neck, 1; arm, 1 ; 
finger, 1 ; breast, 1 ; thigh, 1 ; leg 1. 

2) Five cases of chancre from bites ; cheek, neck, left ear, right upper 
arm, finger (pp. 334. 340). 

3) Sin cases, chancre of eyelids or conjunctiva (one 18 months before 
visit). Source of infection not ascertainable (pp. 380-386). 

4) Case, chancre in Scarpa's triangle, from non-venereal contact in bed; 
wife infects husband (p. 334). 

5) Case, chancre of lip in child of 3 years, infected by mother (p. 333). 

6) Case, chancre near anus, child of 3 years, infected from parents (p. 

333)- 

7) Case, chancre of breast in a female from contact of husband's lips (p. 

333). 

8) Case, chancre of lip, in child of 12 years, from kissing (p. 334). 

Lawrence, W. London. St. Bartholomew's Hospital. 
London Medical Gazette, Vol. V., 1830. 

1) Case, chancre of finger in medical man, from contact with an 
ulcerated fissure (p. 772) (Delpech). 

2) Case, chancre of thumb, in medical man from professional exposure 
(p. 772). 

3) Case, infection of a medical man, from exposure in delivering a low 
woman (p. 772). 

4) Case, chancre of thumb, from venereal exposure" (p. 771). 

5) Case, chancre of nipple, in two wet-nurses, from same nursling 
(p. 808). 

6) Case, chancre of lip, from breast-drawing (p. 808) (Hey). 
"Treatise on Venereal Diseases of the Eye ; " London, 1830. 

7) Case, chancre of upper eyelid (p. 331). 

Lawson. G. London. 

Lancet, London, 1865, Vol. I., p. 478. 

Case, chancre of the eyeiid, in an infant, source unknown. 

Layet. 

"Traite prat. d. 1. vaccin. animal," Paris, 18S9 (Siepe, " Ueber extragen. 
lokal. Initialsclerosen," Inaug, Dissert. Bonn, 1S92, p. 21). 
58 soldiers infected through vaccination, from a nursling aged two 
months. (See Epidemics). 

Lazansky, L. Prague. Univ. Clinic of Prof- Pick. 
Archiv f. Derm. u. Syph., 1878, p. 47. 

Case, child aged 5 years, infected by mother.. 

Lebenwald, A. Styria. 

" Venaesectis noxia.'' Ephem. Acad. Nat. Cur., Decu. II., ann. 5, Norim- 
berg, 1687, Obs. 51, p. 93. (Girtanner, 59S). 
Case, a surgeon bled five persons hastily with a phlebotome, which had 
just been used upon a syphilitic ; all were infected. * 

Leber, T. Gottingen. Univ. Prof, of Ophthalmology. 

(Personal communication to De Beck, q. v., 1886, p. 52). 
Cases of chancre of the eyelid, but no notes. 



ANALYTICAL BIBLIOGRAPHY 319 

Leblanc, R. F. Paris. Hop. des Veneriens. 

"Sur les mal. ven. des enfants nouveau-nes, etc." These de Paris, 1803. 

1) Group of 4 children infected in one family, ages 10 months to 8 
years. 

2) Case, chancre of breast from nursling. (See Bertin 6 ). 
Leckie and Carlton. 

" Communicability of Syphilis through the Saliva," British Med. Journ., 
Dec. 24, 1887, p. 1379. 
Case, infection by tattooing, chancre of both forearms. 
Lecoq. See Gallus. 

Lecoq, J. Cherbourg. Surgeon-Major, Marine Infantry. 
Gaz. des Hopitaux, 1859, Dec. 24, p. 598. 

1) Two cases, vaccino-syphilis in soldiers. (See Guyenot). 
(Cited by Diday, " Chancre de l'amygdale"). 

2) Case, chancre of tonsil, nurse from nursling. 
Le Dentu, A. Paris. Hop. St. Louis, Surgeon. 

Case, nurse infected by nursling. (See Appay). 

Lee, C. G. 

Liverpool Med.-chir. Journ., 1886, VI., p. 226. 
Case, chancre of left upper eyelid, from licking to remove foreign body. 

Lee, H. London. Surgeon to St. George, and Lock Hospitals, etc. 
Medico-Chir. Transac, 1S60, Vol. XLIIL, p. 57. 

1) Case, chancre of upper lip, in an old woman, from her grand-child. 
"Lectures on syphilitic and vaccino-syph. inoculation," 2d ed. , London, 

1863. 

2) Three cases, chancre of finger in medical men (p 252). 

3) Case, chancre of upper lip, from kissing grand-child (p. 256). 

4) Case, infection of a child, from its father (p. 256). 

5) Case, infection of a child and its mother by a destitute girl (p. 258). 

6) Two cases, chancre of tongue, from using a spoon, and kissing (pp. 
260-261) 

(Also cases of Hunter 2, Marston i, Rollet 2, Watson i). 
Lancet, London, 1865, II., p. 623. 

7) Case, chancre, nurse from nursling. 
Lancet, London, 1S6S, I., p. 748. 

8) Case, chancre of left breast, wet-nurse from heredi to-syphilitic infant. 
" Lectures on Syphilis," Philadelphia, 1S75. 

8a) Case of Watson, W. W., q. v. 

9) Case, chancre from vaccination (p. 32). 

ga) Case, chancre finger in physician, from wound in performing crani- 
otomy (p. 33). 

10) Case, chancre of finger, after a suspicious intercourse (p. 41). 

11) Mention of three cases of infection of midwives from W. Clowes' 
" Lues Venerea," London, 1596, p. 35. 

12) Case, nursling infected by nurse, infects four others (p. 35). (Pare, 
Ambrose, quoted by Clowes, case XL). 

12a) "Syphilization," by Danielssen (p. 164). 

"System of Surgery," Holmes, T. "Syphilis," revised by J. N. Hyde, Vol. 
I., p. 176. 

13) Case, chancre of nipple, nurse from nursling (p. 206). 

Lees, D. B. 

(Reported by Hutchinson "Syphilis," p. 118). 

Case, chancre of nipple, mother from own child. (See Hutchinson 18 ). 

Lefeuvre. Paris. 

" Hemiplegie faciale syphilitique." Bull. gen. de ther., 1S66. 

Case, chancre of lower lip, in wife of man suffering from a relapse of 
pre-nuptial syphilis. 



320 SYPHILIS INSONTIUM 

Lefevre. 

(Cited by Cazenave, "Syphilides," 1843, p. 136). 
Case, nurse, infected by nursling. 

Lefort, L. Paris. Hop. du Midi, Prof, of Surgery. 
(Cited by Jullien, " Traite, etc.," 1886, p. 527). 
Five cases of chancre of lip, in total of 464 cases. 

LeGendre, P. Paris. 

" Contrib. au diag. du chancre syph. de l'amygdale." Archiv. gem de 
med., Paris, 1884. 

1) Case, chancre of right tonsil, in man of 25 (p. 68) (Guibout). 

2) Case, chancre of right tonsil, in man of 21 (p. 71) (Brocq. L., service 
of Laboulbene). 

3) Case, chancre of right tonsil (p. 74) (Brocq. L., service of Bucquoy, 
and Anger, Th.). 

4) Case, chancre of left tonsil, in man of 64 (p. 75) (Merklen, service of 
Peter). 

5) Case, chancre of tonsil (p. 292) (the same given by Cullerier, claimed 
by M artel). 

6) Case, chancre of right tonsil, in man of 37 (p. 292) (Hue, A. service 
of Pean). 

7) Case, chancre cf right tonsil, in woman of 63, from a Eustachian 
catheter (p. 294). 

8) Case, chancre of left tonsil, in man of 30 (p. 295) (Launois, E. service 
of Duguet). 

9) Case, chancre of right tonsil, in man of 23 (p. 297) (Fournier, Hulot). 

10) Case, chancre of right tonsil, in a woman, her daughter had chancre 
of the neck (p. 297) (Fournier, Hulot). 

11) Case, chancre of left tonsil, in a virgin (p. 297) (Morel-Lav allee, 
service of Anger, B.). 

12) Case, chancre of right tonsil, in woman of 59 (p. 298) (Spillman). 

13) Case, chancre of left tonsil, in woman of 27, from a child with a 
chancre on the labial commissure (p. 299) (Fournier, Hulot). 

14) Case, chancre on arcus palato-glossus, in man of 28 (p. 300) (Fournier, 
Barthelemy). 

15) Case, chancre of both tonsils, in man of 25 (p. 306) (Mauriac, Rizat). 

Legrand, A. 

" De Tor et du mercure." Paris, 2d Edit., 1842. 

1) Case, infant infected by nurse (p. 171). 

2) Cases of Chrestien, Lallemand, Souchier, Menard, Niel, Dalmas, 
etc. 

Leloir, H. Lille. Clin, of the Med. Coll. and of the Hospital St. Sauveur. 
Annales de Derm, et de Syph., 1882, 2d Ser., Vol. III., pp. 546-548. 

1) Case, chancre between 2d and 3d toes of right foot, in medical 
student of 25 years. 

" Lecons sur la Syphilis," Paris, 1S86. 

2) Two cases, infection in Hospital at Lille (Ward of St. Conce) (p. 44). 

3) Case, chancre left nipple, nurse from nursling (p. 47). 

4) Case, chancre of groin, child of above nurse, by wetting with her 
saliva (p. ',7). 

5) Case, seven chancres of the breast, nurse from nursling (p. 47). 

6) Case, chancre lower lip, from sucking the breast of a syphilitic con- 
fined woman by an adult woman (p. 54). 

7) Cases, infection of more than twenty women, by the above-mentioned 
woman in the same way (Dr. X., of Tourcoring) (p. 54). (See Epi- 
demics). 

8) Case, chancre over Scarpa's triangle (p. 56) (service of Fournier, 
Lavergne and Perrin). 

9) Case, chancre on the face, from coughing of a patient (p. 57). 






ANALYTICAL BIBLIOGRAPHY 3 21 



10) Case, chancre, left angle of eyelid, in a man by a glove (p. 59). 

11) Case, chancre of buccal commissure, from handkerchief (p. 60). 

12) Case, infection by a syringe, in a woman (p. 60). 

13) Case, chancre of lip, in a man from chewing-gum (p. 61). 

14) Case, chancre upper lip, in child, from candy from the mouth of 
syphilitic mother (p. 62). 

15) Case, chancre of gum, from dental instruments (p. 62). 

16) Case, chancre of middle finger, in man of 30, from using porte- 
caustique applied previously to syphilitic persons (p. 63) (service of 
Fournier). 

17) Case, infection of a confined woman, by a medical student (p. 65). 

18) Case of Lailler, q. v. 2 (p. 66). 
Lemonnier, F. 

Annales de Derm, et de Syph., 1SS6, p. 598. 

Case, woman aged 54 years, infected by infant whom she was hand- 
raising; in three months she infected her husband by .coitus. 
Leo, L. Bonn. 

Zeitschr. f. Mediz. (Jan. or Feb. '92) (Journ. de mal. cut. et syph., Vol. 
IV., Feb. '92, p. 93). 
Four women infected by a midwife who drew their breasts, two of their 
husbands became infected; legal process, resulting in imprisonment 
of midwife for six months. 
Leonard, B. (1563). 

(Cited in Archiv f. Derm, u. Syph. Vol. XXI., 1889, p. 59). 
Case, chancre of lower lip. 
Leonesio. Milan. Osped. St. Catarina. (Foundling and maternity). 

Some of the reports given yearly in the Annali universali di med., etc. 
Milan (Ricordi, "Sif. da Allatt.," 1865, q. v., p. 45). 
Statistics: 475 nurses infected by nurslings from 1854-1863. 
Leppmann, A. 

Archiv f. Derm. u. Syph., 1883, pp. 289, 551. 

Many references to vaccinal and other modes of syphilitic infection. 
Leprovost. Paris. Hop. du Midi. (Service of Horteloup). 
La France medicale, 1881, p. 147. 
Case, chancre of the cheek. 
Lesage, E. Paris. 

" Chancre par morsure." These de Paris, 1885. 

1) Case, chancre right thumb from bite (Fournier) (p. 11). 

2) Case, chancre of finger, policeman, from bite (Fournier) (p. 18). 

3) Case, chancre of finger from bite (Brouardel) (p. 19). 

4) Little girl and mother infected from mouth-piece of a clarionette (p. 26). 

5) Case, chancre, dentist from bite of a patient (Fournier) (p. 18). 

6) Case, chancre of cheek, from bite (Fournier, Lavergne and Perrin) 

(P- 9). 

7) Case, chancre left ear, from bite (Hermet, Lavergne and Perrin) 

(p. 13). 
Lesser, E. Leipzig. 

"Ueber Syphilis maligna." Archiv f. Derm. u. Syph., 1882. 

1) Case, man, infected probably per os, from infant's pap-bottle (p. 642). 

2) Case, chancre lower lip, in a man, source unknown (p. 646). 
"Ueber einige Falle erworbener Syphilis bei Kindern." Breslauer Aerztl. 

Zeitschr., 1880, II., p. 277. 

3) Three children of one family, from syphilitic housemaid, all slept 
together. 

" Lehrb. der Haut u. Geschlechtsk.," 6th Edit. p. 112. 

4) Case, chancre, inner angle of right eye. (See Krelling). 
u Syphilis auf Island." Archiv f. Derm. u. Syph., 1S91, p. 37. 

5) A letter of Dr. Sciiierbeck's in Reykjavik, upon syphilis in Iceland. 

22 



322 SYPHILIS INSONTIUM 



Letnik, L. M. 

Vratsch, 1881, No. 2, p. 29. 

Case, chancre of left tonsil, in policeman, of 28 years, from room-mate. 
Letorsay. 

Bull. gen. de therap., Paris, 1855, XLIX. , p. 130. 
Case, nurse infected by nursling. 
Lettsom, J. C. London. Physician to London Dispensary. 
Trans. London Med. Soc, I., 1787, pp. 137-149. 

1) Case of inoculation through implantation of a tooth. 

2) Case of Hamilton's, fatal result after a short interval, from tooth- 
implantation (if syphilitic, atypical) (p. 148). 

3) Case of Kuhn's, local and general symptoms, from tooth-implanta- 
tion ; said to have ceased upon removing the tooth, which need not 
prejudice the diagnosis (p. 145). 

In the "Literatura Medica Digesta," of Plouquet, occurs the following 
meagre reference to Lettsom: "Syphilis — Infectio — per Vulnera — " 
Med. Commun., Edinburgh, Bd. III., p. 310. 

4) Case or cases of inoculation of syphilis .by trauma. 
Letulle, M. Paris. (Service of C. Paul). 

La France Med. Paris, 1878, XXV., pp. 65, 81. 
Case of acquired infantile syphilis. (See Pontet). 
Lever. London. Guy's Hospital. 

"Syph. vaccinale," Acad, de med. de Paris, 1885, p. 175. 
Cases of vaccino-syphilis. 
Lewentaner, M. Constantinople. 

Monatsh. f. prakt. Derm., 18S7, p. 904. 
Case of circumcision-syphilis. 
Lewi, H. J. St. Petersburg. 

Vratsch., 1891, No. 15, p. 390. 

1) Case, chancre of nipple in wet-nurse of 25 years, 

2) Case, chancre of nipple, wet-nurse aged 25 (both at the Dom 
Nursery). 

3) Case, chancre of both nipples, from her own child, who was infected 
by two syphilitic children. 

Vratsch, No. 14, 1892. (St. Louis Med. and Surg. Journ., June, 1892). 

4) Case, chancre, right side of soft palate, in a virgin of 16 years, a 
laundress. 

Lewin, G. Berlin. Charite Hospital and Fried. -Wilh. University. 

" Behandlung der Syphilis durch Sublimat. Einspritzungen, "Berlin, 1870; 
Amer. Edit., 1882. 

1) Case, infection per os, probable double chancre of lip and throat, 
source unknown (case 19). 

2) Six cases of infection per os, location not always given, and nothing 
of etiology (cases 20-25). 

f 3) Case, chancre, lower lip, in girl from lover's kisses (case 26). 

4) Case, woman infected at nipple by nursling ; infects own child per os 
(case 27). 

Berlin, klin. Wochenschr. , 1874. 

5) Case, chancre, both lips, from kissing (p. 313). 

6) Case, chancre of lip, from kissing (p. 313). 

7) Case, two chancres of the lower lip (p. 314). 

8) Case, chancre, right nipple, nurse from nursling (p. 313). 

" Ueber Infectio sinecoitu." Archiv f. Derm. u. Syph., 1875, p. 373. 

9) Case, chancre of breast, nursing mother infected by nursling; infects 
own nursling. 

Deutsche med. Wochenschr., 1S89, p. 1073. (Archiv f. Derm. u. Syph., 
1890, p. 164). 
10) Case, chancre of lower lip, in 25-year-old girl. 



ANALYTICAL BIBLIOGRAPHY 323 

Archiv f. Derm. u. Syph., 1891, p. 1000. 

11) Case, chancre of upper lip, in 25-year-old man-servant. 

Berliner dermatol. Verein., Sitz. Dec. 3, 1891. (Archiv f. Derm, u Syph., 
Vol. XXIV., 1892, p. 508). 

12) Case, chancre, index finger, in a young man, cause not stated. 

Lewy and Goldberg. St. Petersburg. 

Vratsch No. 10, 1892 (St. Louis Med. and Surg. Journ., June 1892). 

1) Case, chancre, lower lip, in man of 30 years, cause not stated. 

2) Case, chancre, left anterior pillar of fauces, in woman of 35, from an 
infant. 

3) Case, chancre, left nipple, in married woman of 35 years, cause not 
stated. 

4) Case, chancre, upper lip, in unmarried woman of 33 years, cause not 
stated. 

5) Case, chancre, upper lip, in married woman of 35 years, cause not 
stated. 

6) Case, chancre, upper lip, in unmarried woman of 32 years, cause not 
known. 

7) Case, chancre, left tonsil, in unmarried woman of 26 years, cause not 
known. 

8) Case, chancre, upper lip, in married man of 40 years, from cigarette 
stubs picked up in the street. 

9) Case, chancre, both nipples, in married woman of 25 years, no cause 
given. 

10) Case, chancre, lower lip, in married man of 28 years, no cause given. 

11) Case, chancre, left tonsil, in unmarried woman of 50 years, no cause 
given. 

Lillie. 

(Rollet, "Traite," etc, p. 473). 
In 1777 Lillie was sent to Jutland to study "Syphiloid" which prevailed 
there. 

Lindestolpe. L x psala. Swedish physician of 18th Century. (Not mentioned 
by Girtanker). 
Work on venereal disease (p. 35). (Rosen von Rosenstein, p. 727). 
Case, youth infects his sister by kissing. 

Lindstrom, A. A. Kiew. 

Milit. arztl. Zeitschr. , 1889. (Archiv f. Derm. u. Syph., 1890, p. 700). 

1) Three cases, chancre of the lip. 

2) Case, chancre of breast, nurse 25 years old, from nursling. 

3) Two cases, chancre of tonsil; soldier aged 28, and boy aged 11. 

Lindwurm. 

" Ueber Syphilisation," Aerztl. Intelligenzblatt, Miinchen, i860, Nos. 13-14, 

P- 175. 
Case, chancre of upper lip in 17-year-old girl, source unknown. 

Linne. 

Nutrix noverca. Amoenit., ac. III., 1756, p. 267. (Cited in Monatsh. f. 
prakt. Derm., 1888, p. 200). 
Cases, of lactation syphilis. 

Lipp, E. Gratz. 

Allgem. med. central. Zeit'g, Berlin, 1879, XLVIII., p. 673. 

1) Two cases, chancre of upper lip, source unknown. 

Verein der Aerzte in Steiermark, Weiner med. Wochenschr, 1889. 

2) Case, chancre inner angle of right eyelid, in a man ; source of infection 
not stated (p. 558). 

3) Case, chancre right lower eyelid in woman 54 years old ; infection 
probably from caring for a syphilitic child (p. 895). 






324 SYPHILIS INSONTIUM 

Lister, M. York. Physician to Queen Anne. 

"Tract, de quibusdam morb. chron." London, 1737. (Roussel, "Syph. 
tertiare," 1881, p. 203). 
Child infected by nurse. 
Lloyd, P. A. Carlisle, England. 
Lancet, London, 1890, II., 123. 

1) Case, chancre at left angle of mouth, in recently married woman of 
25 years. 

2) Case, chancre lower lip, in a soldier, attributed to smoking another's 
pipe. 

3) Case, chancre on left brow, just at edge of scalp, in married woman 
of 44 years. 

Loder, J. C. Gottingen. 

(Rosen von Rosenstein " Kinderkrankheiten," 6th Edit. Gottingen, 1798). 

1) Case, man infected by a privy-seat, just vacated by one with lesions 
of the privates (p. 729, foot note). 

2) Many women infected from breast-drawing by a dissolute female, 
with venereal sores of the lips (p. 729, foot note). 

Lodge, J. W. 

Phil. 'Med. Times, 1871, I., p. 150. 

Case, syphilitic (?) eruption, after vaccination. 
Loew, A. (With Wedel, G. W.). 

" De lue venerea." Inaug. Dissert, Jense, 1682. 
(Cases of Petronius, and Rivierus). 
Lorain, P. Paris. Hop. St. Antoine. 

(Reported by Petit, " Transmis. de la syph. par la vaccine." These de 
Paris, 1867, p. 15). 
Case of vaccino-syphilis, in which infection occurred through blood 
transferred to the vesicle-floor by the needle. 
Lorenzo, G. di. Naples. 

Giorn. ital. d. mal. ven., etc., 1866, Vol. II., p. 91. 

Case, chancre, right angle of mouth, child 4 years. old, from mother. 
Lorenzutti. 

"Specimen inaug. med. de pecuhare syphilidis quadam forma nomine luis 
Fluminensis sive morbi de Scherlievo nota. " Patavia, 1830.* 

Loret. 

" Proces verbale d. Congres. d. Nantes." (Diday, q. v., "Inf. Syph.," p. 

175). 
Family epidemic; nurse, her mother, and her daughter, three genera- 
tions, infected through use of spoon used in feeding a foster-child. 
Loring, E. G. New York. Eye and Ear Infirmary. 
(Notes of cases published by Sturgis, q. v.). 

1) Case, chancre, right lower eyelid, child 22 months old. 

2) Case, chancre of cheek, six-year-old sister of the above. 

Lorinser, F. 

" Ueber die Skerljevo-Krankheit im osterreichischen Kustenlande, Wiener 
med. Woch., 1865, Nos. 93, 94.* 
Lortet. Lyons. Professor of Natural History. 
Gaz. med. de Lyon, June ti, 1864. 

Case of Eustachian infection in a lady. 

Lorut. Paris. 

(Cited by Fournier " Chancre cephalique," 1858). 
Case, chancre of the lip. 
Lossius, L. Giessen. 

" Dissert, de lue venerea," 1668, c. 2, § 3. 

By this reference Plouqhf.t cites Lossius, under the caption, 
" Per Salivam — Osculum — Suctum." 



ANALYTICAL BIBLIOGRAPHY 3 2 5 



Lotz. Basle. 

Report of sanitary com. to Swiss Council. (Cited by Fournier, " Syph. 
Vacc," p. 52, note). 
Estimates 750 known cases of vaccinal- syphilis up to 1880, as follows: 
Italy 300, France 120, Austro-Hungary 68, England 36, Scotland 1, 
Denmark 7, Prussia 85, Bavaria 17, America 1. 

Lowdell, G. 

London med. Gaz., 1842, p. 467. 

1) Two cases, chancre of nipple, nurses from nurslings. 

2) Case, nursling infected by nurse (its mother). 

Lubelski, G. Warsaw. 

Medycyna, 1880. (Rev. d'hyg. et de pol. sanit., Paris, 1881, p. 577)- 

1) "Epidemics of circumcision-syphilis, past and recent. (See Matla- 
kowski). 

Annales d'hygiene. 1881, VI., p. 157.* 

2) Syphilis communicated by circumcision. 
Lubinsky, A. Cronstadt. 

Klin. Monatsbl. f. Augenheilk., April 1878, p. 166. 

1) Case, chancre of left inner canthus of the eye. 
Med. prib. k. Morsk. Sborn., 1880, XX. 

2) Case, chancre of upper left eyelid. 
Lucas, R. C. London. Guy's Hospital, Surgeon. 

" Practitioner," 1882, p. 352. 
Case, chancre of upper lip. 
Lucas-Championniere, P. Paris. 

" Recherches prat, sur la therap. de la syphilis" (from observations in 
service of Cullerier, neveu, Chief of the Hop. des Veneriens). Paris, 
1836. 

1) Case, nursling infects nurse, she her own nursling (p. 9). 

2) Family epidemic, all infected through a foster-child, by using the 
same spoon and cup (p. 10). 

3) Several cases of syphilis in infants acquired from adults with pustular 
syphilides. (Cited by Cazenave). 

Lunkevitch, M. V. Tiflis. 

Proc. of the Caucasian Med. Soc, 1887, No. 7, p. 162. Prov. Med. Journ., 
1887, p. 422. 
Case, chancre of the finger, from fighting. 
Lusitanus, (Amatus). 

"Curat, med. cent, sept.," 155.;, C. I., No. 49. (In " Aphrodisiacus"). 
(Cited by Audoynaud, ' Syph. comm. par allaitement.'' These de 
Paris, 1869, p. 9). 
Nurse infected by nursling, infects her husband and two other nurslings, 
who infect their mothers. 
Lusterbourg. Lyons. 

(Case reported by Bottex, q. v.). 

Lustreman. Prof. 1' Ecole du Val-de-Grace. 

(Cited by Ricord " Lettres sur la syphilis," Paris, 1863, p. 86). 
Case, chancre, lower eyelid, in a lawyer, infected by finger. 

Lutaud. 

"Note sur deux cas chancres indures extra-genitaux." Journ. de med. 
de Paris, p. 276. (Szadek, Index bibliog. syphilidol., Jahrg., 1886, 
p. 18). 

Liith. Burtschied, Austria. 

(Case reported by M. vox Zeissl, q. v.). 

Luzinsky. Vienna. Kinder-Krankeninstitutes zu Marishilf. 
Wiener med. Wochenschr., 1856, VI., pp. 134, 149, 167. 



326 



SYPHILIS INSONTIUM 



i) Case of syphilis, child infected by wet-nurse, infects older sister and 
mother. 

2) Case of syphilis, wet-nurse infected by a suckling infant, infects 
another nursling after the first one died/ 

3) Case of syphilis in a child, thought to be acquired from a syphilitic 
nurse ; mother infected by child gave birth to a syphilitic infant, who 
in turn infected its nurse. 

Allgem. Wiener med. Zeit'g, 18S4, No. 15. 

4) Statistics; conditions of syphilis in infants and children. 

5) Two children infected by a nurse, infect their mother. 

6) Case, child infected by a nurse, mother sleeping with child was 
infected, and bore syphilitic child which infected another nurse. 

Lydston, G. F. Chicago. 

New York Medical Record, 1884, p. 39. 

1) Two cases, chancre of the lip, aunt and grand-mother, from caressing 
heredito-syphilitic infant. 

" Lectures on Syphilis," Chicago, 1885. 

2) Case, surgeon, late Dr. Nott, chancre middle finger, from operating 
on a syphilitic (p. 22). 

Journal Amer. Med. Ass'n, 1886, p. 652. 

3) Case, chancre of tongue, from kissing. 

4) Case, chancre of gum, from dentist. 
Medical Register, Philadelphia, 1888, p. 194. 

5) Case, chancre of lip, supposed to be from drinking-cup on railway 
train. 

Lyle, A. New York. 

New York Medical Record, 1891, p. 158. 

Case, acquired syphilis in 4-year-old child, possibly from rape. 
MacCarthy, D. J. Paris. Hop. du Midi. (Interne). 

" Du diagnostic et de 1' enchancement des symptomes 
These de Paris, 1844. 
Cases, chancres, lip 3, chin 2, tongue 1, gum 1, nostril 1 
McCraith, J. Smyrna, Asia. 

Med. Times and Gaz. , 1859, I., p. 289. 

1) Case, infant infected by kiss of maid-servant. 

2) This infant gave chancre of breast to its v/et-nurse. 

3) This wet-nurse infected two of her own children. 

4) The maid-servant had acquired the disease from 
in the village from which they came, syphilis 
epidemic. 

Med. Times and Gaz., 1877, I*. P- 3 2 3- 

5) Two cases, nurslings infected by nurses. 

6) Case, chancre of nipple, nurse from nursling. 

Macdonald, A. Glasgow. 

Edinburgh Med. Journ., 1873, July, XIX., p. 30. 

Case, chancre of tonsil, in middle-aged man from nursing-bottle of an 
infant. 

McGuire, J. C. Washington, D. C. 

Amer. Practitioner and News, Louisville, 1886, p. 257. 

1) Case, chancre of lip from drinking-vessel. 

2) Case, chancre of lip, in a man, who infected 

3) His wife, by kissing, who infected 

4) Her six-year-old son, chancre of tonsil. 

5) Case, chancre on end of thumb- 

Mackay, G. Edinburgh. 

Med.-chirurg. Soc. of Edinburgh. Edinburgh Med. Journ., XXXIV., No. 
3, Sept., 1888, p. 2C2. 
Case, chancre of upper eyelid, in 6-year-old boy, from kiss by its 



syphilitiques. 
hand 4. 



a young girl, and 
was found to be 



ANALYTICAL BIBLIOGRAPHY 327 

mother ; the latter claimed to have been infected by tooth-pick used 
by syphilitic boarder. 
Mackenzie, Morell. London. Metropolitan Throat Hospital. 
"Diseases of Throat and Nose," Philadelphia, 1880, p. 100. 
Statistics: has seen seven cases, chancre of tonsil, 6 women and 1 man; 
no particulars (total personal experience). 
MacKenzie, W. Glasgow. Univ. Clinic for Eye Diseases. 

"Pract. Treatise on Diseases of the Eye,'' London, 1855, 4th Ed., p. 
161-2. 

1) Case, chancre of eyelid, 7-year-old boy, from an adult room-mate. 

2) Case, chancre of conjunctiva, thought to have followed kissing in 
situ. 

Maclaren, P. H. Edinburgh. Lock Hospital. (Surgeon). 
"Atlas of Venereal Diseases," Edinburgh, 1886. 

1) Case, chancre of finger, from tooth-inoculation. (Plate X). 

2) Case, chancre of thumb, from infant grand-child, with hereditary 
syphilis, from washing clothing, etc. (Fascie V., no plate). 

Macleod, J. 

"De syphilitide insontium," Dissert. Inaug., Edinburgh, 1805, pp. 90.* 
Macnamara, C. London. 

(Reported by Hutchinson "Syphilis," London, 1887, p. 116). 
Epidemic of syphilis from circumcision. 
Maes. 

Deutsche med. Woch., 1891, No. 34, p. 1017. 

Case, chancre of eyelid after incision of a hordeolum. 
Malm, O. 

Norsk Mag. for Lsegevidenskab, 1886, 4, R. I., p. 714. (Archiv f. Derm. 
u. Syph., 1887, p. 385). 

1) Two cases, chancre of tonsil. 

2) Three cases, chancre of tonsil. (See Inell). 

3) Seven cases of French authors. 

Manassei, C. Rome. Univ. Clinic for Skin Diseases and Syphilis. 

Report of Dispens. of S. Maria Gallicano. Giorn. ital. d. mal. ven., 

etc., 1877, p. 354. 
Statistics, 1S74-6, of 73 cases of syphilis: chancre lip 2, breast (nurses) 2. 
Also cases reported by Rasori and Ravogli assistants (q. v.). 

Manassein, M. P. St. Petersburg. 

\ ed tsinskoe Obozrainie, 1889, XXXI., No. 4, p. 407. 
Case, chancre lower lip in a soldier, probably from eating or drinking- 
utensils; mess-mate had "bad disease." 

Manganotti, Orsino. 

Giorn. ital. d. mal. ven. e della pelle, XXVII. , Mar. 1892, p. 32. 
Case, chancre right angle of lower lip, in man of 37, from a kiss. 

Mannino, L. Palermo. Ospizio d'Trovatelli. 

"Una piccola epidemica d. sifilide," etc. Palermo, 1886 (from L'lngras- 
sia, Palermo, 1885, p. 347). 
Nurse and her parents, old people, infected by a foundling by lactation, 
hand-feeding, etc. 

Manssurow, N. Moscow. 

"Syph. der fibrosen Gewebe," etc. Archiv f. Derm. u. Syph., 1S81, 

* P- 391- 

1) Case, chancre of lip, in dry-nurse, age 29 years, from infant (p. 412). 
Klin. Sammelsch. f. Derm. u. Syph., Moscow, Feb., II., 1S87, pp. 59-07 

(Archiv f. Derm. u. Syph., 1889, p. 881). 

2) Two children infected by wet-nurse ; infection supposed to be conveyed 
through the milk. 



328 SYPHILIS INSONTIUM 



Marc. Paris. 

(Acad, de Med., 1852, " Syphilisation ," etc., reported by Roux, q. v.). 

1) Case, chancre of fauces from kissing. 

(Reported by Profeta, q. v., "Tratt. prat.," etc., Palermo, 1888, p. 417). 

2) Case, infection from a privy-seat. 
Marcolini. Udine. 

"Sulla complicaz. d. vaccina," Milan, 1823. (Annali universali di med., 
1824, XIX., and Barbantini, q. v. 1 ). 

1) Epidemic of vaccination-syphilis, 1814. (See Epidemics). 
Memoire med. chirurg., Milano, 1829, p. 18 (quoted by Rayer, "Traite," 

etc., 1835, p. 862).* 

2) Treats of Facaldina. 

Marey. Paris. 

(Cited by Fournier, " Chancre cephalique," (q. v.), Obs. 17, cp. V.). 
Case, chancre of the cheek (notes by Marey). 
Marfan, A. B. Hop. Necker. Chief of Clinic (service of Prof. Peter). 
Annales de Derm, et de Syph., Vol. I., 3d Ser., 1890, p. 499. 

Case, chancre right septum nasi, in 17-year-old man; virus probably 
conveyed to nose on finger, from vulva of a woman. 

Margoniner, J. Berlin. Prof. Rosenthal's Policlinic. 

" Beitrage z. d. Primaraffect. d. Syph.," Monatsheft f. prakt. Derm. VI., 
No. 11, 1887. 

1) Case, chancre upper lip, woman 21 years old, from kissing (p. 491). 

2) Case, chancre of hard palate, in a gold-smith, 45 years old from blow- 
pipe infected by a colleague (p. 497). 

Marianelli, A. Assistant in the Clinica Dermo-sifilopat. of Pisa. 

"Resoconto sommar. dei casi occorsi dal 1 Nov., 18S7 al 31 Dicemb., 
188S." (Reprint from Riforma Med. Aug., 1890). 

1) Case, chancre at angle of jaw, in man 26 years old (p. 17). 

2) Eleven cases of syphilis in nurses, five contracted from nurslings in 
p'rivate families, and six from foundlings (p. 29). 

"Resoconto sommar. dei casi occorsi nell'anno, 1889." Milan, 1891. 
(Reprint). (Giorn. ital. d. mal. ven.,etc. Mar. 1891, p. 74)^ 

3) Four cases of extra-genital chancre, observed in the Clinic of C. 
Pellizzari; lower lip 1, chin 1, nipple 1, and 1 at upper end of natal 
fold in a girl of 15 months (p. 9). 

Marjoline. Paris. Hop. St. Eugenie. Surgeon. 
Bull, de la Soc. de Chirurgie, 1871, p. 259. 
Mother and infant infected about same time, when latter was 4 months 
old; source not given. 

Marlow, F. W. Syracuse, N. Y. Prof, of Ophthal. in Med. Dep. Univ. of 
Syracuse. 
New York Medical Journal, 1890, LI., p. 237. 

Case, chancre of upper eyelid in a woman, 49 years old, from a grand- 
child with inherited syphilis. 

Marmisse. 

Gaz. des Hop., Paris, 1862, No. 16, p. 62; 1863, pp. 441, 454. 

Case, chancre of nipple, nurse from nursling; she in turn infects her 
husband. 

Marone. 

rimparziale, 1862, No. 5. 

1) Epidemic of vaccino-syphilis, 1856, Lupara and Molise. (See Bouvier \ 
and Epidemics). 

2) Cases, described in series and type, few singly; among latter is 
10-year-old girl, chancre lip and tongue, from wet-nurse, through 
breast-drawing. 



ANALYTICAL BIBLIOGRAPHY 3 2 9 



Marston, J. A. Assistant-Surgeon Royal Artillery. 
Lancet, London, 1862, II., p. 232. 
Case, chancre on face, inoculation by patient's finger. (See H. Lee 6 ). 
Martel. Paris. 

Case, chancre of tonsil. (See LeGendre 5 , and Cullerier 4 ). 
Martelliere, E. D. Paris. 

" Del'angme syphilitique." These de Paris, 1854. 

1) Case, chancre of tonsil, in a domestic (Obs. X., p. 43). 
(Cited by LeGendre, Archiv gen. de med., 1884, p. 65). 

2) Thiee cases, chancre of tonsil (seen by Martelliere). 
Martin, A. Paris. Hop. St. Lazare. (Interne). 

" De l'accident primitif de la syph. constitution elle." These de Paris, 
1863. 

1) Statistics collected by Bureau. (See Clerc '). 

With Belhomme, L. " Traite des malad. verier." 2d Ed., 1876, p. 77. 

2) Statistics compiled for the work of Burlet and Rollet (q. v.) (p. 119). 

3) Family epidemic from Eustachian infection . 

4) Case, chancre, developing in a razor-cut. (Carre, q. v.). 

•' De l'infection spyhilitique de la ville des Tanniens," Paris, 1803, p. 14.* 
Martineau, L. Paris. Hop. de Lourcine. 

1) Cases reported by Binet and DesMolines (q. v.). 

" De la propag. de la syph. et de sa prophylaxie," Paris, 1881. (L'Union 
med., Paris, 1SS1, 3d Ser., XXX., p. 580). 

2) Case, chancre of lip, in chamber-maid, from employers, by mouth- 
piece of a speaking-tube. 

Martins, C. F. Paris. Hop. St. Louis. (Interne, service of Biett). 

"Mem. sur les causes gen. des syph.," 1838. Revue med. franc, et 
etrang., Paris, 1838, I., pp. 24-74, 184-235. 
Case, chancre of nose. (See Biett 8 , reported by Ricord). 

Mason, F. London. 

St. Thomas' Hosp. Reports, Vol. IV., N. S., 1873. 

1) Three cases, chancre lower lip, source unknown. 

2) Case, chancre lower lip, in a glass-blower. 

3) Case, chancre lower lip, in a cornet player. 

4) Two cases, chancre of eyelid (personal communication, H. Lee). 

5) Case, chancre of finger, in medical student, professional exposure. 

6) Case, chancre, abdominal wall, male aged 24 years. 

7) Case, chancre of thigh, Wm. T., aged 29. 

8) Case, chancre left upper arm, from vaccination. 

(Cases of Ambrosou, Bryant, Churchill, Cooke, Coote, Couper, 
Critchett, Diday, Drysoale, Fournier, Hardy (Murray), Hill, 
Holthouse, Hutchinson, Jones, Lee, Maunder, Paget, Quain, 
Sigmund, Skinner, Stanley, Watson). 

Massa, N. Venice. 

" De morbo Neapolitano." Basel Collection, 1536, pp. 104-5. 

1) Statement: has seen many infected without lesions of genitals. 

2) Statement: prevalence in children, too old for lactation, too young 
for coitus. 

3) Statement: frequency of transmission, by eating and drinking-vessels, 
kissing, common bedding, etc. 

4) Three cases, within a year, children aged 3, 6, and 11 years. 

5) Case, infection by exposure to unclean bed-linen. 

Massei, F. Naples. 

"Pathol, u. Therap. des Rachens, der Nase, u. des Kehlkopfs," (Germ, 
trans. Leipzig, 1892. Dr. Em am its Fink, p. 205). 
Case, chancre of tonsil, (coitus praeternaturalis) observed by Guntz, 
q. v. 



33° SYPHILIS INSONTIUM 

Mastin, W. M. Mobile, U. S. A. 

Gaillard's Medical Journal, 1880, XXX., p. 14. 
Case, chancre of the eyelid. 
Matlakowski, W. Warsaw, Poland. 

Article on Circumcision Syphilis (seven observations) Medycyna, 1880, 
VIII., p. 401. 

1) Cases of Bierkowski, q. v. 

2) Cases of Nowakowski, q. v. 

3) Cases of Kosinski, q. v. 

4) Cases (personal). 
Maudon, J. A. 

" Histoire de la syphilis des nouveau-nes et des enfants a la mamelle." 
These de Paris, 1853, with plate.* 
Maunder, C. F. London. London Hospital. 

Lancet, London, 1861, II., p., 475; Med. Times and Gaz., Feb. 1, 1862, p. 
no, and in Mason, q. v. 

1) Two cases, chancre of lip, removed for epithelioma. 

2) Case, chancre of finger. 

Maunsell, J. 

Lancet, London, 1877, L, p. 633. 

Case, chancre of lower lip, in a cigar-maker. 
Mauriac, C. Paris. Hop. du Midi. 

Gaz. des Hop., Paris, 1874, Nos. 81, 82, p. 642. 

1) Cases, three chancres of the lip, and. one of the chin. 

2) Case, chancre on the thigh in boy 10 years old. 

3) Case, infection of sister of preceding boy. 

"Lecons sur la syph. prim.," Pans. (Also in La France med., 1880, 
XXVII. , pp. 137, 345)- 

4) Case, chancre or the back, female (p. 323). 
" Lecons sur les mal. vener.," Paris, 1883. 

5) Six cases, chancre of lip (pp. 326, 442, 443). 

6) Four cases, chancre from shaving; upper lip, 2, cheek, 2 (pp. 262, 
272, 329, 394). 

7) Four cases, chancre of tongue (pp. 271, 327, 443, 444). 

ja) Case, chancre lower part lumbar region in woman from husband 
(p. 271). 

8) Three cases, chancre of tonsil (pp. 328, 443). 

9) Four cases, chancre of fingers (pp. 323, 445, 446). 
10) Three cases, chancre of chin (pp. 327, 443). 

n) Case, chancre of eyelid (p. 445). 

12) Several women infected by an accoucheur (p. 272). 

13) Cases, chancre, abdomen, p. 445; thigh, p. 956; anus, p. 447. ' 
(See also Rizat, Viguier, and Zwetitch). 

Maurin. Paris. Hop. St. Louis. (Service of Vidal). 

Case, chancre of tongue. (See Vidal). 
Maury, F. and Dulles, C. W. Philadelphia, U. S. A. 
Amer. Journ. Med. Sci., Jan., 1878, LXXV., p. 44. 

Fifteen persons infected from tattooing, by a syphilitic tattooer. (See 
Epidemics). 

Maxwell, J. 

" Observations on Yaws and its influence in originating Leprosy," etc., 
Edinb., 1839. 

Mayer. Berlin. 

" Merkwiirdige Infectionsweise der Syphilis." Journ. f. Chir. u. Augen- 
heilkunde, Berlin, 1839, 28, pp. 460-465.* 

Mazet. 

Journ. des mal. cutan. et. syph., Vol. IV., Mar., 1892, p. 113. 






ANALYTICAL BIBLIOGRAPHY 331 

Case, chancre, right upper eyelid, in man of 24 years, who at the same 
time had a chancre of the penis. 
Meighan, T. S. Glasgow. 

Glasgow Med. Journ., Sept., 1SS3, 4th Ser., XX. (Med. Times and Gaz., 
1885, I., p. 5). 

1) Case, chancre, left lower eyelid, inoculation through having a "black 
eye" lanced, and the wound sucked by a syphilitic (p. 211). 1 

2) Case, chancre of eyelid, in a youth, infection probably from dressing 
sores of a room-mate with recent syphilis (p. 212). 

Menard. 

(Cited by Legrand, "De l'or et du Mercur," Obs. 178-180, p. 188). 

1) Case, chancre of breast, nurse from nursling. 

2) Case, yearling child, infected by mother who had just borne previ- 
ously mentioned child. 

Mensinga. 

Internat. klin. Rundschau, Wien, 1888, II., p. i486. 

Nurse infected by nursling of second generation, with secondary 
syphilis. 
Mentzel, J. C. Physician to the King of Russia. 

Ephem. Acad. N. C, Dec, III., Niimberg, 1706 (Girtanner, p. 332). 
Case, woman 60 years old, infected from tending her son. 

Meric, Victor de. 

British Med. Journ., 1874, I., p. 105. 

Case, chancre, left tonsil, married man, wife mucous patches in mouth. 
Mericamp, J. P. Paris. Hop. St. Louis. (Interne, service of Fournier). 

(See Guignard). 
Merklen, P. Paris. 

Annales de Derm, et de Syph., 1881, p. 673. 

Case, chancre, left tonsil, simulating epithelioma, in woman of 64 years. 
Merz, L. 

Archiv de tocologie, Jan. 1S90. 

1) Two cases, nurses infected by nurslings. 

2) Case, chancre of breast, mother, from nursing own child, exception 
to Colles' law. (Also a similar case cited from Tommasi-Crudeli, 
q. v.). 

Messarosh, P. I. Astrakhan. 

Meditsinskoe Obozrainie, 1S91, XXXVI., No. 17, p. 426. 

Case, chancre, upper lip, in a man 20 years old, with chancroid on penis. 
Metzger. 

" Ueber den gememschaftlichen Kelch." Gruner's Almanach f. Aerzte u. 
Xichtarzte. Jena, 1786, pp. 110-114.* 

Meyer. Mindern. 

" Verbreitete Syphilis durch cine syphilitische Amme." Med. Zeit'g, 
(herausg. v. vereine f. Heilkunde in Preussen) Berlin, 1838, June 13.* 
Syphilis spread by a nurse. 

Meyer-Ahrens. Zurich. 

Schweitz. Zeitschr. f. Nat. u. Heilk., N. F., Bd. III. (Behrend's Syphilid., 1 
1844, p. 552). 
First appearance of syphilis in Switzerland, and laws to prevent its 
spread by cupping, sheltering wayfarers, etc. 

Michaelsen. 

" Identitat der sogenannten Dithmarsischen Krankheit mit den geralteten 
aligemeinen Syphilis." Oppenheim's Zeitschr. f. die gesammte 
Medicin, Bd. XXL, 1842, p. 433. (Quoted by Boeck, "Traite d. 1. 
Radesyge," etc., 1SO0, p. 47).* 
He considers the morbus Dithmarensis as a syphilis invetere. 



33 2 SYPHILIS INSONTIUM 



Michahelles, G. C. C. W. 

" Das malo di Scarlievo," Nuremb., 1833. 
Also a brief mention of " Mai di Breno" (p. 21). 
Michel. Erlangen. 

" Krankh. der Lider " Graafe u. Saemisch's Handb. d. gesammten 
Augenheilk., Leipzig, 1876, p. 417. 
1 1) Case of Solomon, J. V. (q. v.), chancre lower eyelid, in 8-months-old 

child, from its aunt. 

2) Case of Mackenzie, W., chancre of lower eyelid. 

3) Case of Stellwag von Carion (q. v.), chancre inner angle eyelid, con- 
taminated by finger. 

4) Case of Desmarres (q. v. 1 ), chancre of eyelid in medical man, cough- 
ing in face. 

5) Case of de Wecker, L. (q. v.), chancre of lower eyelid. 

6) Case of Ricord, chancre external angle of eyelid. 
Michel, J. Paris. Hop. Lourcine. (Interne, service of Fournier). 

(Case reported by Appay, q. v. 3 ). 

Case, chancre of breast, nurse from nursling. 
Middleton, F. Santiago. 

Bolet. de med., Santiago, 1884-5, !•» P- 383. 

1) Case of vaccino-syphilis in a nursling. 

2) Case, infection of wet-nurse by above nursling. 
Migneco, R. Catania, Sicily. Dermo.-syph. Institute of Catania. 

" Relazione clinica per l'anno, 1890/' Edit. Galati, Catania, 1891 (Archiv 
f. Derm. u. Syph., Vol. XXIV., 1S92, p. 114). 
Statistics; among 89 chancres observed (77 men and 12 women), only 
one extra-genital, a man with a chancre in the inguinal region. 

Mikhailoff, N. F. Moscow. 

Trans, of the 4th gen. meeting of Russian medical men at Moscow, 1S91, 
No. 8, p. 271. 

1) During 1884-86, 28 wet-nurses contracted syphilis in the " Moscow 
Foundling Home." 

2) Six Zemsky practitioners, report in 3 }^ears, 105 peasant women in- 
fected by infants sent from above " Home " to rustic farmers. 

3) They also report 20 cases of infants infected by wet-nurses. 
(These 153 cases, had not been previously reported). 

Mikulicz, and Michelson. 

"Atlas der Krankheiten der Mund u. Rachenholle" (Siepe, "Ueber extra- 
genital lokalisirte Initialsclerosen.'' Inaug. Dissert, Bonn, 1892, 
p. 11). 
Case, chancre of upper and lower lip, in man of 23 years. 

Milbank, R. New York. 

Archives of Pediatrics, 1884, I., p. 161. 

Case, chancre of genitals in a child, source unknown. 

Millard, V. Paris. Hop. Beanjon. Physician. 
L'Union med., 1865, No. 147. 

1) Group of seven cases, of vaccino-syphilis, from same vaccinifer. 
(Reported by Budor, q. v.). 

2) Case, chancre of lip, followed by tabes dorsalis. 

Milroy, G. 

"Leprosy and Yaws in the West Indies," 1873.* (Fox and Farquhar, 
" Skin and other Diseases of India," etc., 1876, p. 5). 

Milton, J. L. London. 

"A History of Syphilis," London, 1S79, p. 66. (Reprinted from the Edmb. 
Med. Journ.). 
An account of Sibbens and other endemic syphiloids. 



ANALYTICAL BIBLIOGRAPHY 333 

Minkevitch, J. J. Tiflis. 

Proc. of the Caucasian Med. Soc., 1887, No. 7, p. 162. (Prov. Med. Journ., 
1887, p. 442). 
Case, chancre of finger, midwife from delivery. 
Minot. Boston. 

Boston Med. and Surg. Journ., 1889, CXXI., p. 608. 
Case, chancre of lip, in a husband, the disease communicated to wife. 
Mireur, H. Bordeaux. 

"Essai sur hered. de la syph.," These de Paris, 1867. (Cited by Fournier, 
" Syph. et Marriage," p. 39). 
Case, child 2 years old, infected by its father's kisses. 

Mitchell, H. 

Lancet, London, 1SS7, I., p. 622. 
Case, chancre of cheek. 
Mittasch, H. 

"Die syphilitischen Erkrankungen der Augenlider. " Dissert. Wiirzburg, 
1883, p. 42. (Archiv f. Derm. u. Syph., Vol. XX., 1888, p. 17). 
Case, chancre of eyelid. 
Moffat, A. D. Glasgow. 

British Med. Journ., 1888, II., p. 1198. 

Case, chancre of lip, no particulars as to mode of infection. 
Moffet, G. E. Surgeon, English Army. 

"Communication of syphilis by tattooing," Lancet, 1887, II., p. 910. 

1) Case, chancre of left forearm, C. M., aged 21 years. 

2) Case, chancre of right forearm, T. G., aged 15 years. 

3) Case, chancre below the insertion of right deltoid, W. C, aged 21 
years. 

Molenes, Paul de. Annales de Derm, et de Syph., 1891, p. 378. 

Case, chancre of right tonsil ; case of reinfection after 3 years. 
Molliere, D. Lyons. 

(Cited by Jullien. "Traite des mal. ven.," 1886, p. 589). 
Case, chancre of forefinger, from a bite. 
Monell. New York. ' 

New York Med. Times, 1854, p. 404. 
Case of vaccino-syphilis. 
Monnet. 

Journ. des mal. cutan. et syph., 1891, p. 268. 

1) Case, chancre of cheek, child one year old. 

2) Case, chancre of upper lip, child 5 years old. 

3) Case, chancre left commissure of mouth, child 7 years old. 
(All infected by mother). 

Monteggia, G. B. Milan. 

" Annotazioni pratiche sopra i Mali Yenerei," Milan, 1794. 

1) Case, nursling infects nurse; she her own infant, who received a 
chancre of the upper lip (p. 244). 

2) Case, nurse infects nursling of 16 months (p. 244). 

3) Case, nurse infects nursling of 10 months (p. 244). 

4) Case, nursling infects nurse (p. 247). 

5) Case, nurse infected by own son, infects a nursling (p. 250). 

6) Case, old woman infected in spoon-feeding a foster-child (p. 255). 

Montgomery, H. B. Chicago. 

Transactions Illinois State Med. Assoc, for 1885. 

Two cases, chancre of conjunctiva, from contamination by the tongue, 
in seeking to remove foreign bodies. 

Moore, W. D. 

Med. Times and Gaz., London, 1866, I., p. 88. (Extr. from Norsk Maga- 



334 SYPHILIS INSONTIUM 

zin for Laegevidens., XIX., No. II., Christiania, November, 1885, 
Dr. Owre, q. v.). 

1) Case, chancre of umbilicus in a male. 

2) Two cases, chancre of lip in girls. 

3) Four cases, chancre of breast, nurses from nurslings. 

4) Case, infection of child by woman with secondary syphilis who took 
care of it. 

5) Case, infection of child, nursling from nurse. 

6) Two cases, chancre of penis in boys aged 4 and 6 years, no coitus. 
Mora, A. and Soresina, G. B. 

"Contr. clin. relat. al met. d. Pr. Scarenzio per la cura d. syph. const," 
Giorn. ital. d. mal. ven. e del. mal. d. pel., 1870, p. 286. 

1) Case, chancre of nipple, nurse from nursling, G. M., aged 23 years. 
Giorn. ital. d. mal. ven. e del. mal. d. pel., 1871, pp. 266, 268. 

2) Two cases, chancre of nipple, nurses from nurslings. 
Morand and Lassonne. 

(Cited by Lugol "Researches on Scrofulous Dis.," New York, 1845, p. 100). 
Lactation epidemic at Montmorenci ; ' ' most of the nurses in this province 
were affected with syphilis." (See Epidemics). 
Morax. 

Cases of vaccino-syphilis (reported by Bouvier, q. v.). 
Morel-Lavallee, A. Paris. Hop. St. Louis, Chief of Clinic. 
Annales de Derm, et de Syph., 1883, p. 39. 

1) Case, chancre of tonsil, female, V. P., aged 22 (Hop. Lariboisiere, B. 
Anger, q. v.). 

Annales de Derm, et de Syph., 1886, p. 85. 

2) Case, chancre of eyebrow, E. G., aged 42, from bite (Hop. Lariboisiere, 

SlREDEY, q. V.). 

Annales de Derm, et de Syph., 1887, p. 701. 

3) Case, chancre inside left nostril, B. C, aged 39 (Service of Four- 
nier). 

4) Case, chancre upper lip, female, M. P., aged 24 (Service of Fournier). 
Annales de Derm, et de Syph., 1888, p. 375. 

5) Statistics, Fournier' s clinic 1887-8 : extra-genital chancres, 45 ; chancre 
of lip (upper, 9, lower, 7), total, 16; chin, 6 (two in razor-cuts); 
tongue, 2; eye, 2; cheek, 2 (one from razor, one from bite); nose, 2; 
tonsil, 1 ; breast, 8; anus, 2; abdomen, 2; thigh, 1 ; hand, 1 ; finger, 1; 
thumb, 1. 

6) Case, chancre, left tonsil from pencil, T., aged 18 (Case of Calmette's). 
L'Union med., Paris, 1887, XLIV. , p. 1. 

7) Case, chancre right nipple, source unknown (one of the above). 
Morgagni, J. B. 

De sed. et causis morborum, Nona ed. cur. Chaussier et Adelon VI., 1822, 
pp, 210-216 (Ep. XLIX., 32) (Montash. f. prakt. Derm., 1888, p. 203). 
Syphilitic infection from a cadaver. 
Morgan, J. Dublin. Lock Hospital. 

Med. Press and Circular, London, July 28, 1869, p. 77. 

1) Case, chancre, angle of mouth, grand-mother from grand-child. 
"Pract. Lessons on the Nat. and Treat. . . . contag. dis.,'' London, 1872. 

2) Two cases, chancre of lip, girls from kisses, betrothed. 

3) Two cases, nurses infected by nurslings. 

4) Family epidemic ; among the victims, an old lady was infected per 
os from tending her grand-child. (See above article). 

5) Case, chancre of fingei, surgeon, from an infant. 

Mori, R. 

L'Ippocratio, Fano, Forli, 1871, XXXIV., Nos. 14, 15, p. 451. 
Epidemic of vaccino-syphilis at Fiume, 1870; thirty-five victims with 
many secondary infections. (See Epidemics). 



ANALYTICAL BIBLIOGRAPHY 335 



Morozoff. 

The Sci. I Kwai Medical Journal, Oct., 1890, p. 164-5. 
Case, chancre of upper lip. 
Morpain. Paris. r Hop. du Midi. (Interne). 

(Fournier "Etude sur la chancre ceph.," 1S58). 

Case, chancre at labial commissure, in woman of 25 years. (Obs. 12). 
Morris, Henry. 

Case of infection by the milk of wet-nurse (?) (See Nunn, T. W.). 

Morrow, P. A. New York. Surg, to Charity Hosp., Univ., Clin, for Ven. Dis. 
Journ. Cutan. and Ven. Dis., 1884, p. 149; 1889, p. 148. 

1) Case, chancre of chin in razor cut. 

2) Case, chancre root of nose (seen in Mexico). 

Moseley, B. Chelsea. 

"A Treatise on the Lues bovilla," London, 1805. 
Of 504 cases of "lues bovilla," some are probably vaccino-syphilis ; 
one infant afterwards infected its mother by lactation. 

Moty. Saida. Hop. Militaire. 

Gaz. des Hop., Paris, 1881, LIV., No. 128, p. 1020. 

Case, chancre of eyelid from wash-water used in moistening dressings 
on a venereal subject. 

Moulon, de. 

" Nouvelles observations sur la nature et le traitement de Scherlievo," 
Milan, 1834.* (Pressemed., 1837, Mai, No. 35). 

Moura. Rio Janeiro. 

"Chancro infect, d. palpebras," Rio, 1889. 
(Known by title only). 

Moure, E. jf. Bordeaux. 

Revue de laryngologie, July 1, 1887 (Annales de Derm, et de Syph., Vol. 
IX., 188S, p. 596). 

1) Case, chancre on septum nares, supposed contagion by fingers. 
(Reported by Dupond, q. v., These de Bordeaux, 1887). 

2) Case, Eustachian-sound infection. 

3) Case, chancre of fauces. 

"Un nouveau cas de chancre indure de la fossa nasale." Feret et Fils, 
Bordeaux, 1892. 

4) Case, chancre left nasal fossa in man of 25 years, mode of infection 
not given. 

Moutard-Martin. Paris. Hop. Cochin. 
(See Cayla '). 

Mracek, F. Vienna. (Venereal clinic, Sigmund). 

Wien. med. Woch., 1879, Nos. 18, 44; Allg. Wien. med. Zeit'g, 1879, 

No. 43. (Cases repeated in following article): 
Wien. med. Presse, 1880, XXI., pp. 9, 47, 87, 113, 142. 

1) Eight cases, chancre of lip, mostly from kissing. 

2) Two cases, chancre of tongue, one from drinking- vessel. 

3) Case, chancre of chin, source unknown. 

4) Case, chancre behind right ear, from a kiss. 

5) Case, chancre of finger, nurse in syphilitic ward. 

6) Case, chancre back of left hand. 

7) Case, chancre right wrist. 

8) Case, chancre right nipple, from kiss. 

9) Chancre of abdomen, 2; right nates, 1 ; left thigh, 1. 

Miiller. F. W. Leipzig. 

"Grundriss der Pathol, u. Therap. d. vener. Krank.," Leipzig, 1882. 
Case of Eustachian infection, without particulars. 



33& SYPHILIS INSONTIUM 

Multanowski. 

Medycyna, 1880, No. 26. (Archiv f. Derm. u. Syph., 1889, p. 247). 

Eight cases of circumcision-syphilis, by application of mouth to prepuce. 

Munk, Hans. 

"Om Radesygen i Stavanger Sygehus," 1799. Todes med.-chir. Journ. 
Vol. V., No. 1.* (Quoted by Boeck, "Traite d. 1. Radesyge," etc., 
i860, p. 21). 
Munninks. J. Groningen. 

"Hist, d'un mal. ... a Groningse en 1804." Dissert. Inaug., 1805. 
Epidemic from breast-drawing. (See Epidemics). 
Murzin, L. N. Moscow. Miasnitsky Hospital for Syphilis. 
Meditsinskoe Obozrenaie, 1890, No. 1, p. 26. 
Two cases, chancre upper eyelid, infection from saliva applied to the 
eye for the cure of a stye. 
Musitanus, C. Naples. 

" Waag. Schaale der Venus-Seuche," Hamb., 1700, p. 64. 
Infant adopted into a Sorrentine convent, infected a wet-nurse and later 
nearly all the nuns, by kissing or tending it. (See Epidemics). 
Musset, H. Paris. 

L'Union med., Paris, 1852, p. 587. 

Case, chancre of tongue in a pregnant woman. 
Muys, Joh. 

(Observation reported by Schurig, q. v.). 
Nggel, E. Tubingen. Univ. Prof, of Ophthalmology. 

(Reported by De Beck, "Hard chancre of eyelids and conjunctiva," 1886, 
P- 52). 
Statement: has seen cases, chancre of the lids and conjunctiva, no 
notes. 
Nassans, A. Hop. du Midi. (Ex-interne). 

(Reported by Fournier, " Chancre ceph," 1S58). 

Case, chancre of lip, in 25-year-old subject. (Obs. 16). 
Nasse, F. Bonn. Univ. Prof, of Clinical Medicine. 
(Reported by Ruthenburg, q. v. Obs. II., III.). 

1) Case, chancre of lip, in a young virgin. 

2) Case, chancre of gum, in a child of six months, probably from 
mother. 

Nayler, G. London. Surgeon to Skin Hosp., Blackfriars. 
British med. Journ., 1865, I., p. 359. 

1) Three cases of syphilis following vaccination, chancres in site of 
inoculation. 

" Diseases of the Skin." 2d Edit., London, 1874. 

2) Two cases, of vaccinal syphilis (seen with Mr. Startin, q. v.). 
Neisser, A. Breslau. Univ. Clinic for Skin Diseases and Syphilis. 

(Ca>es published by Friedlander, Kopp, Lesser, Arning and others, 
q. v.). 
Nelaton, A. Paris. 

(Reported by Laroyenne 2 , q. v.). 
Three cases, chancre of eyelid. 

Nettleship, E. London. St. Thomas' Hosp., Eye Clinic, Surgeon. 
British Med. Journ., 1875, II., p. 363. 

1) Case, chancre, within the nostril. 

(Related in Hill and Cooper's " Syphilis," etc. London, 1S81, 2d Edit.). 

2) Case, chancre of left lower lid, in child 3 years old. 

Neumann, Isidor. Vienna. Gen. Hosp., Div. for Skin Diseases and Syphilis. 
Allg. Wien. med. Zeit'g, 1886, p. 57. 

1) Case, child infected by servant's kisses, infects 

■ 



ANALYTICAL BIBLIOGRAPHY 337 



a) Its mother; b) its grand-mother, chancre of tongue; c) its sister, 
aged 4 years. 
Allg. Wien. med. Zeit'g, 1883. 

2) Three cases, chancre of lip (lower, 2 ; upper, 1) (pp. 297, 307). 

3) Case, chancre of hand, midwife, professional inoculation (p. 307). 

4) Case, chancre ball of thumb, from bite. ( 

5) Case, chancre of nipple, nurse from nursling. 

6) Case, chancre second finger, auto-inoculation (p. 308). 

7) Case, multiple chancre of chin, man from caressing syphilitic infant 
(P- 297). 

Allg. Wien. med. Zeit'g, 1884, p. 62. 

8) Case, chancre of finger, dentist, from extracting tooth from syphilitic. 

9) Case, chancre of hand, from bite (see above, 4). 

10) Case, chancre of tonsil, child from candy sucked by a syphilitic. 
Wien. med. Blatter, 1883 Nos. 18, 19. 

11) Case, old woman, infected by kissing grand-child. 
Atlas der Hautkrankh., Wien, 1885, L., IV., Taf. 55. 

12) Case, chancre upper lip in a female. (Plate). 

Aerztl. Ber. des K. K. allg. Krankenh. zu Wien., 1888 (publ. 1890), p. 103. 

13) Case, chancre upper lip and right ala nasi, girl aged 20. 

14) Case, chancre lower lip, right side, woman aged 38. 

15) Case, chancre breast, wet-nurse from nursling. 

16) Case, chancre forearm, woman 24, from washing clothes of syphilitic. 

17) Case, chancre left tonsil, married woman of 30, probably from using 
table-utensils in common with a syphilitic. 

18) Case, chancre right tonsil, man aged 35. 

Wien. klin. Wochenschr., 1890, III., pp. 2S2, 307, 323, 344, 386. 

19) Statistics: 613 cases from literature summarized according to 
location. 

20) Statistics: 86 personal cases, extra-genital chancre, during ten years. 

21) Cases, chancre, upper lip, 18; one from bite, one from drinking-glass, 
rest from kissing. 

22) Cases, chancre, lower lip, 28 ; three women from kissing, one from 
table-utensils, one woman from grand-child with inherited syphilis, 
sucking on her lip, the rest from kissing. 

23) Cases, chancre corner of mouth, 8 ; one from smoking old cigar 
stump. 

24) Cases, chancre of cneek, 2 ; both from kissing. 

25) Cases, chancre of chin, 5 ; in four, infection probably from a razor. 

26) Case, chancre, pharynx and soft palate, source unknown. 

27) Cases, chancre of tonsil, 2; in one, from spoon previously used by 
syphilitic. 

28) Cases, chancre, ala nasi, 3 ; in one case a woman, washing a vessel 
used by a syphilitic for local bathing, frequently rubbed an excori- 
ated place on the ala nasi. 

29) Two cases, chancre of eyelid. 

30) Cases, chancre, fingers and hand, 11; one acquired while washing 
infected linen, one from a bite. 

31) Cases, chancre of nipple, 4; one from a bite, one from kiss of a 
syphilitic man, and two from diseased nurslings. 

32) Case, chancre of umbilicus in a child from sleeping with its mother, 
who had been infected by her husband in eighth month of pregnancy. 

Verhand. der Wiener Dermatol. Gesell., Sitz. Mar. 23, 1892. (Archiv f. 
Derm. u. Syph. Vol. XXIV., 1892, p. 855). 

33) Case, chancre middle of upper lip in cigarette girl, infection possibly 
from cigarettes. 

Neves da Rocha. 

" Cancro duro da palpebra." O Brazil medico, 3.* (Szadek, " Index bib. 
Syph.," 4th Jahrg., p. 33). 



33% SYPHILIS INSONTIUM 



Newsky, A. 

Meditsinskoe Obosren., 1884, No. 21, p. 779. (London med. Recorder, 1885, 
p. 1 IT). 
Case, chancre of tongue in virgin, probably from table-ware. 
Niece, Ch.-de la. Pans. Hop. St. Louis. (Service of Fournier). 
Annales de Derm, et de Syph., 1886, 2d Ser., VII., p. 225. 

Case, chancre right elbow, infection probably by scratch with soiled 
finger. 
Niel, J. G. Montpellier. 

(Cited by Legrand, " De l'or et du Mercur," p. 167). 
. Two cases, nurses infected by same nursling. 
Nikolsky, D. P. St. Petersburg. 

Vratsch., 1891; XII., 987. (Monatsh. f. prakt. Derm., 1892, p. 113). 

1) Case, chancre right side of face, near angle of jaw, from shaving. 

2) Statement: among the peasantry of Russia 50 to 90 per cent, of cases 
of syphilis are by extra-genital infection. 

3) Statistics from literature. 

Nikolsky, V. J. Tambow Gouvernment. Physician. 
Vratsch., 1886, No. VII., pp. 735-738. 

Statistics: five years in peasantry of his district; 15.7 per cent, of all 
cases of sickness due to syphilis. 
Niobis. Rive-de-Gier. 

(Cited by Lancereaux, "Treatise on Syphilis," London, 1869, Vol. II., 

P- 245)- 
Ten cases of syphilis in glass-blowers, seen before 1858. 

Nivet, X. Paris. Hop. St. Louis. (Interne, service of Fournier). 

" De la treq. relat. des .... chan. syph. extra-genit." These de Paris, 
1887 (Annales de Derm, et de Syph., 1887, p. 813). 

1) Statistics: 47 extra-genital chancres during year 1886, Hop. St. 
Louis. 

2) Statistics; 595 extra-genital chancres in Fournier' s public and private 
practice during about 30 years ; lip, 268 ; tongue, 37 ; tonsil, 29 ; gum, 6 ; 
palate, 3; uvula, 2; pharynx, 1; mouth, 1; chin, 31; eye and eyelids, 
15; cheek, 11; nose, 11; neck, 8; ear, 4; face, 2; temple, 1; forehead, 
1 ; submaxillary region, 1 ; breast. 34; fingers, 31 ; hand, 5 ; clavicle, 2 ; 
arm, 1; elbow, 1; forearm, 1; anal region, 50; abdomen, 20; thigh, 

12; buttocks, 3; great trochanter, 1; calf, 1; malleolus, 1. 
Nodet, L. Lyons. Hospice de l'Antiquaille. (Service of Rollet). 
" Etude sur les div. espec. du chancre." These de Montpellier, 1863. 

Statistics: of 65 cases of syphilis, there were six extra-genital chancres; 
lip, 4; eyelid, 1 ; nostril, 1. 
Noekentved. Franekjser, Denmark. 
Hospitalstidende, March 1, 1893. 

1) Case, chancre lower lip, in a man, whose pipe was smoked by 
another with mucous patches. 

2) Three additional cases of syphilis, acquired probably through the 
common use of pipes or table-utensils, from the infecting agent in the 
first case. 

Nott, J. C. New York. 

Auto-infection, chancre of finger, from operation. (See Lydston). 
Notta, M. Paris. 

La France Medicale, 1885, II., p. 14S6. 

Case, chancre, upper and lower lip, in a 20-year-old man, probably from 
kiss. 

Nowakowski. Warsaw, Russia. 

(Reported by Kosinski, 1867; Lubelski, 1880; and Matlakowski, q. v. 2 ). 
Epidemic of circumcision-syphilis, Warsaw, 1864-5. 



ANALYTICAL BIBLIOGRAPHY 339 

Noyes, H. D. New York. Bellevue College, Prof, of Ophthalmology. 

(Reported by De Beck, "Hard chan. of eyelids and conjunct," 1886, p. 52). 
Statement: has seen cases of chancre of eyelids, but no notes. 
Nunn, T. W. 

Lancet, London, Dec. 26, 1891, p. 1435. 

1) Case, chancre of lower lip, near angle of mouth. 

2) Case of infection by milk of wet-nurse (Henry Morris, q. v.). 
Obalinski. Krakow. Univ. Prof, of Surgery. 

(Reported by Jaffe, q. v.). 

Two cases of circumcision-syphilis. 

Obedenare. Bucharest. 

Proc. Soc. de Chirurg. de Paris, 1875, p. 141. (Cited by Roussel, " Syph. 
tertiare," Paris, 1881, p. 155). 
Case, chancre of both nipples, probably infected by own child. 
Obtulowicz, F. Krakow. Clinic of Prof. Rosner. 
Virchow-Hirsch Jahresb., 1876, II., p. 545. 

Case, nursling infected by mother (a case similar to that of Arning, q. v.). 
O'Connor, D. C. Cork, Ireland. Workhouse Hospital. 

Dublin Quart. Journ., June, 1846 (Lancet, London, June 20, 1846). 

1) Case, infection, nurse from nursling. 

2) Case, chancre of nipple, in mother of preceding nursling. 

3) Case, infection, child of nurse, through spoon-feeding the nursling. 
(This episode the cause of a court trial, see Egan, "Syphilit. Diseases,'' 
p. 294). 

Dublin Quart. Journ. of Med. Scien., 1858, XXVI., p. 205. 

4) Case, chancre of nipple, nurse from nursling. 

5) Case, infection of a nurse by nursling. 
Oedmansson, E. L. Stockholm. Univ. Prof, of Syphilis. 

Nord. Med. Ark., 1869, I., 4, p. 1 (plate). 
Case, infection of a nurse by a nursling. 
Oesterlen, Fr. 

' ' Hist, -kritische Darstellung des Streits uber die Einheit oder Mehrheit 
der venerischen Contagien," Stuttgart and Augsburg, 1836. 
Case, chancre of fauces, m girl of 18 years, virgin with undeveloped 
genitals (p. 182). (See Reich and Langenbeck). 
Oestreicher. 

Berlin, derm. Verein., Sitz., Nov. 5, 1889; Archiv f. Derm. u. Syph., Vol.. 
^ XXIII., 1891, p. 837. 

Case, chancre of left cheek, from razor-cut, in man of 30 years. 
Ohmann-Dumesnil, A. H. St. Louis, U. S. A. 

St. Louis Med. and Surg. Journ., LV., 1888, p. 354 (Annales de Derm. 
et de Syph., 1888, p. 718). 

1) Case, two chancres, hard palate, near gum, man aged 54, from smok- 
ing a pipe used by others. 

Monatsh. f. prakt. Derm., 1S88, p. 877 (N. Y. Med. Record, 188S, p. 590). 

2) Two cases, chancre of lip, coincident with chancre of prepuce. 
St. Louis Clinique, Vol., IV., No. 2, p. 67. 

3) Case, chancre of tonsil. 
International Clinics, Oct.. 1891, p. 188. 

4) Case, chancre of the thumb. 
Oilier, L. Lyons. Prof, of Clinical Surgery. 

"Traiteexperim. et clin. des os," etc., Paris, 1867, Vol. II., p. 46 (Cited by 
Roussel, "Syph. tertiare," p. 129). 
Case of vaccino-syphilis (also described in part by Bouilly, q. v.). 
Olympios. 

Correspondenzbl. Bayr. Aerzte, 1840, p. 185 * (Lancereaux, "Traite," etc. , 
p. 42). Speaks of "Spirocolon." 



34° SYPHILIS INSONTIUM 

Orlandini, C. Milan. 

Gaz. Med. ital. Lombardia, Milan, 1865, No. 18. 
Case of vaccino-syphilis. 
Ory, E. Paris. 

" Contrib. a l'etiol. d. syphilides malignesprecoces," These de Paris, 1875. 

1) Three cases of Besnier, St. Louis, 1875; two chancres of the upper 
lip and one of the chin. 

2) Case, Bourdon, Charite, vaccino-syphilis, from unclean scarifier. 

3) Case, Vidal, Academy vaccination, malignant syphilis, 1870. 

4) Case, chancre of finger, in a physician ; no particulars. 

5) Case, Woillez, Lariboisiere, 1873, chancre of upper lip. 

6) Two cases, Lailler, fiancees, afterwards married, each chancre of 
lip, man infected woman. 

7) Case, Vidal, St. Louis, 1874, chancre upper lip from drinking-glass. 

8) Case, Guibout, St. Louis, 1875, chancre upper lip from drinking-glass. 

9) Case, Vidal and Lailler, St. Louis, 1871, probable chancre of fauces, 
1863. 

10) Case, Lailler, St. Louis, two nurses infected by nursling. 

11) Case, Hardy, unpublished, chancre upper lip, near time of confine- 
ment. 

12) Case, Hardy, St. Louis, 1865, midwife infected on hand. 

13) Case, Labbe and Coyne, Pitie, 1872, chancre upper lip, man aged 52. 

14) Two cases, Hardy, girls, chancre forearm, carrying child (p. 25). 

Osiander. 

"Denkwiirdigkeiten," Bd. II., 1, p. 100. (Plouquet). 
Syphilis insontium " per occubationem in eodem lecto.'' 

Ostroumoff, Fedor V. 

"Statistics of Syphilis in the Tcherepovetz Uiezd" (Novgorod Government, 
North Russia). Tcherepovetz, 1889. 

a) Syphilis prevails endemically in 90 per cent, of villages. 

b) Attacks especially garrison soldiers, then follows clergy (16.6 per 
cent, of the total number of syphilitics). 

c) Children, under 5 years of age, constitute 15.3 per cent, of total of 
syphilitics. 

d) Congenital syphilis more frequent in male than in female infants, 
all other forms more frequent in women than in men. 

(?) Syphilis is spread mainly in a non-sexual way. 
■/) Little children infected mostly, through feeding bottles, etc. ; sub- 
jects of other ages from family life , towels, utensils, etc.; clergy 
through ritual kissing during Easter service, and some other 
ceremonials, peculiar to the " Orthodox" religion. 

Otis, F. N. New York. Prof. Ven. Dis. , College of Physicians and Surgeons- 
"Clin. lect. on phys.-pathol. and treat, of Syphilis," New York, 1881, p. 
101 (New YorkMed. Record, Aug., 1878, XIV., p. 128). 

1) Three cases, chancre right forefinger in medical men. 

2) Case, surgeon, chancre right forefinger, from puncture of spicula of 
bone, while amputating leg of syphilitic. 

3) Case, chancre of lower lip, from fiance, kissing (p 102). 

4) Case, chancre, right angle of mouth, physician, from pipe. 

5) Case, chancre, angle of mouth, from dentist. 

6) Case, chancre lower lip, from lead pencil. 

" Pract. clin. lessons on Syphilis," etc., New York, 1883, Vol., I. 

7) Eight cases, chancer of finger in medical men (including above four) 
(p. 38). 

8) Case, chancre lower lip, man aged 38, from kissing. 

Ottava, Ignatz. Buda-Pesth. Univ. Eye Clinic. (Assistant). 

Szemeszet, No. 3, 1882 (Monatsh. f. prakt. Derm., 1887, p. 284). 
Case, chancre upper eyelid, girl aged 22. 



ANALYTICAL BIBLIOGRAPHY 34 1 

Otterson, W. C. 

New York Med. Times, 1863, N. S., IV., No. 23, June 6, p. 267. 
Epidemic of vaccino-sypnilis ; 80 soldiers inoculated out of 300. (See 
Epidemics). 
Otto. 

Trans. Provm. Med. Assoc, 1839, VII., p. 212.* (Hirsch, Handb. der 
histor. geograph. Path. Stuttgart, 1883, II., p. 74). 
Report on " Syphiloid" of Jutland. 
Owen, E. London. 

Lancet, London, 1881, p. 378. 
Case, chancre of lip. 
Owre. 

Eleven cases extra-genital chancre. (See Moore, W. D.). 
Ozanam. 

Traite des mal. epidem., t, IV., p. 282.* (Quoted by Rollet, "Traite 
des mal. ven.," p. 460). 
Upon the subject of Scherlievo. 
Pacchiotti. G. Turin. Surgeon, Univ. Clinic. 

"Sifil. trasmessa p. mezzo d. vaccinat. in Rivalta," Torino, 1862. 

1) Forty-six cases, infection from vaccination (pp. 19-27). (See Epi- 
demics). 

2) Twenty-six cases, infection, nurses from nurslings (pp. 46-48, 66). 

3) Case, chancre of lip and tonsil, in boy of 11 years (p. 51). 

4) Case, chancre of tonsil, in girl of 13 years, sister of one of above- 
mentioned vaccinated children (p. 51). 

5) Case, chancre of forearm, in girl of 12 years, sister, from carrying 
one of the vaccinated children (p. 52). 

Paget, Sir J. London. St. Bartholomew's Hospital. 
Lancet, London, Oct. 15, 1870, p. 536. 

1) Case, chancre of tongue. 

Report of Army and Navy Commission, etc., 1867. 

2) Statement: has seen plenty of cases of chancres on lips and fingers; 
the latter especially in medical men (p. 395). 

Quoted by Marion Sims, q. v. ; reference not given. 

3) Over fifty cases in medical men, from professional infection. 
Paget, Stephen. London. Sen. Assist. Surg., Metropolitan Hosp., and West 

London Hosp. 
" Chancre of the lip," Lancet, London, April 16th, 1892, p. 856. 
Statistics collected from various sources and mention of two cases with- 
out details. 
Palfyn, J. Ghent. 

" Heelkondige ontleedning von menschen lichnam," Leyden, 1718., 
(Girtanner, No. 810). 
Cases of midwives professionally infected. 
Paliard. Lyons. 

Lyon med., 1872, IX., p. 36; X., p. 481. 
Case, chancre of forehead. 
Panas. Paris. Univ. Prof, of Ophthalmology. 
(Cases related by Delapersonne, q. v. 1 , 2 ). 
Two cases, chancre of eyelid. 

Pancritius, F. W. T. Berlin. Geheim. Sanitatsrath. 
" Ueber Lungen-Syphilis," Berlin, 1881. 

1) Case, chancre of finger, in a physician, by vaginal exploration (Obs. 
I., p. 72). 

2) Case, chancre of finger, cause not given. (Obs. 6S, p. 205). 

3) Family epidemic from wet-nursing. (Obs. 4, p. 223). 

4) Case, chancre of lip, source not given. (Obs. 10, p. 234). 



34 2 SYPHILIS INSONTIUM 

5) Case, chancre of lip, from kissing. (Obs. 18, p. 245). 

6) Case, chancre of tonsil, in a woman from her affianced. (Obs. 2, p. 
291). 

Pare, Ambrose. Paris. Surgeon to Henri II. , and III., Francis II., and 
Charles IX., of France. 
" Oeuvres completes," 1585, 4th Edit., p. 701. (Cited by Audoynaud, 
" Syph. commun. par allaitement," These de Paris, 1869, p. n). 
Family epidemic, introduced by an infected wet-nurse. 

Parinaud, H. Paris. 

Case, chancre of eyelid. (Reported by Brocq, q. v. 2 , (service of 
Besnier). 
Parker, Langston. Birmingham. Queen's Hospital, Surgeon. 
Lancet, London, 1858, I., pp. 526, 606. 

1) Two cases, chancre of nipple, from breast-drawing. 

2) Case, wet-nurse infected by nursling. ' 
Parola. 

" La dottrina vaccinica," 2d Edit. 

per mezzo d. vacc," Torino, 1862, p. 4). 
Partridge, E. L. New York. 

New York Med. Journ., 1880, p. 303. 
Case, chancre of lip from kissing. 
Passani. 

Gazetta medicale di Milano, Oct. 14, 1843. (Cited by Leppmann, Archiv 
f. Derm. u. Syph., 1883, p. 543). 
Cases of vaccinal syphilis. 
Paul, C. Paris. 

(Reported by Letulle, q. v.). 

Case, chancre of lip in boy of 6 years, from mother. 
Paulini, C. F. 

Obs. med. phys., in Append. Eph. Nat. Cur., Ann. 5 (Girtanner, p. 278). 
Alleged infection from pulverized bone of syphilitic subject (?). 
Pauly, R. Lyons. 

Annales de Derm, et de Syph., Vol. III., June, 1892, p. 690. ' 

1) Case, chancre lower lip, in man of 38 years, in whom 14 years later two 
chancres appeared on left cheek. (Service of Cordier): 

Soc. de sciences med. de Lyon, Nov., 1891. (Journ. des mal. cut. et syph., 
1892, p. 342). 

2) Case chancre of forehead in man of 48, wound inoculation ; 6 weeks 
later a chancre appeared on right cheek. (Service of Cordier). 

Pavlov, P. S. Moscow. 

Medits. Obozrenaie, 1890, No. 1, p. 12. (Archiv f. Derm. u. Syph., 1891, 

P- 327); 

1) Statistics: 45 cases of extra-genital chancre. 

2) Among 1236 syphilitic men, 10 cases (0.8 per cent.) were extra-genital; 
tonsils, 2 ; nose, 2 ; upper lip, 3 ; lower lip, 1 ; tongue, 1 ; back of 
hand, 1. 

3) Among 165 syphilitic women, 12 cases (7.27 per cent.) were extra- 
genital; breast, 6; lower lip, 2 ; tonsil, 1 ; soft palate, 1 ; upper gum, 1. 

4) Among 43 children, 23 cases extra-genital chancre. 
Payne, R. L. Lexington, N. C, U. S. A. 

North Carolina Med. Journ., 1879, IV., p. 119. 

1) Case, syphilis in infant, from' syphilitic cousin, by kissing. 

2) Case, chancre of breast, in mother of preceding, fron nursing. 
P6an. Paris. Hop. St. Louis, Surgeon. 

Case, chancre of right tonsil (reported by Hue, q. v.). 
Pease, W. A. 

Cincinnati med, and dental Journ., 1S86-87, II. 



ANALYTICAL BIBLIOGRAPHY 343 

i) Case, chancre of nipple, nurse-mother from nursling (?) (p. 294). 
2) Two cases, infection after tooth extraction (p. 297). 

Peatson. Manchester. 

British med. Journ., 1S60, II., p. 594. 
Case, infection of child of 4 years by parents ; it had slept with its 
mother. 

Pellizzari, C. Pisa. Univ. Clin, of Dermatology and Syphilis. 
Gioin. ital. d. mal. ven., etc., 1879. 

1) Statistics: wet-nurses, 69; infants, 54(30 buccal chancres); adults, 
extra-genital, 70 cases (chancre of lip, 30). 

2) Case, infection nursling from nurse (p. 32S). 

3) Case, chancre of tonsil, mother from nursling (p. 324). 

" Delia transmissione accidentale della syphilis," Milan, 18S2 (also Giorn. 

ital. d. mal. ven., etc., 18S2, pp. 193, 257, 323). 
3 a ) Case, chancre of anus in an infant, from a piece of cloth (Brochure, p. 

33)- 

4) Five cases, infection, nurses from nurslings, infect their own and 
other children (p. 209). 

4a) Case, chancre right cheek, in girl of 16, from carrying a syphilitic 
infant (Brocure, p. 52). 

5) Five cases, infection, nurses from nurslings (p. 209). 

6) Case, infection, nurse from nursling, infects its mother (p. 209). 

7) Case, infection, nursling from nurse, infecting his four-year-old 
brother (chancre on left angle of mouth) (p. 214). 

8) Cases, lactation epidemic ; nurse infected by infant, infects her own 
and three other children, these infect three mothers and aunt (p. 200). 

9) Case, chancre of hairy scalp, from a comb, infant (case of P. Pelliz- 
zari) (p. 219). 

10) Case, infection, nursling, from mother (p. 221). 

11) Nine cases, chancre of the lip, from common use of utensils. 

12) Case, infection of a child, from kissing, infects its mother (p. 215). 

13) Case, chancre of lip, workman using his comrade's glass (p. 260). 

14) Case, chancre of lip, pregnant woman, drinking at public fountain 
(p. 261). 

15) Case, chancre of lip, in student, from a pipe held only a moment 
(p. 263). 

16) Cases, infection of four persons by eight-year-old. girl, infected by 
coitus (p. 219). 

17) Case, chancre, right arm, in child of 4 years, from vaccination 
(p. 223). 

18) Case, chancre of chin, in man of 48, infecting his wife, chancres on 
cheek and sub-clavian region, by means of plaster fallen from sore 

(P- 273)- 

19) Case, chancre, right submaxillary region, from contact with chancre 
of chin (p. 274). 

20) Case, chancre of leg, in child w T ith infantile paralysis, transmission 
by the brush electrode (case of Del Greco) (p. 271). 

21) Case, chancre of breast, nurse from nursling, infecting 

22) Husband, and 9-year-old boy, chancres on the eyelids (p. 276). 

23) Case, chancre, right hand, in Prof. P. Pellizzari himself, while per- 
forming version (p. 279). 

24) Case, infection of a medical man, from professional exposure (p. 279). 

25) Case, chancre, righc index finger, from assisting at operation on 
syphilitic man (p. 2S1). 

26) Cases, chancre of tonsil, 4; neck, 1 ; cheek, 1 ; arm, 1 ; chin, 1 ; chest, 1; 
mouth, 1 ; anus, 2 (from contact). 

La Nuova Clin. Dermosifil. di Siena, 1884. 

27) Case, chancre, lower lip, in woman of 27 years (p. S3). 

28) Case, chancre of nipple (p. S2). 



344 SYPHILIS INSONTIUM 

Giorn. ital. d. mal. ven., etc., 1884, p. 173. 
29) Case, chancre, right inguino-scrotal fold in 16-months-old child, 
sleeping with parents (p. 9). 
Pellizzari, P. Florence. Univ. Prof, of Dermatology and Syphilis. 

Lo Sperimentale, Florence, 1862, No. 4 (British med. Journ., May 10, 1862, 

P- 4i5)- 

1) Case, chancre left arm, Dr. Bargioni, from inoculation of blood from 
syphilitic woman (experiment failed on Drs. Rosi and Passagli). 

" Can Syphilis be transmitted by the milk?" Giorn. ital. d. mal. ven., 
etc., Vol. II., 1866. 

2) Case, chancre of eyelid in child, from sleeping with syphilitic mother; 
contact with her saliva (p. 219). 

Report of Clinic, 1873-74 (Giorn. ital. d. mal. ven., etc., 1875). 

3) Five cases chancre of tonsil (p. 316). 

4) Three cases, chancre of lip (p. 316). 

5) Case, chancre of finger (p. 316). 

6) Case, chancre of nipple, nurse from nursling (p. 317). 
Penny, W. J. Bristol, England. 

Bristol Med.-Chir. Journ., 1888, p. 46. 

1) Case, chancre of lip, from shaving; probable re-infection. 

2) Case, chancre of gum, sailor aged 32; thought to be from tooth- 
brush. 

Peola. 

" Relazione al Consiglio Sanitario Provinciale di Alessandria," 1874. 
Epidemic of vaccino-syphilis at Alexandria, 1873 ; sixteen directly inocu- 
lated. (See Epidemics). 
Percival. Aiken, S. C, United States. 
(Reported by Jones, q. v.). 

Epidemic of vaccino-syphilis, during American Civil War ; about one 
hundred and fifty victims. (See Epidemics). 
Pernhoffer, Gustav von. 

' ' Untersuchungen u.. Erfahrungen iiber das Krankheitsiibel Skerljevo, 
etc.," Wien, 1868, p. 156. 
Complete treatise on Scherlievo, with many references. 
Perrin, L. Marseilles. 

Annales de Derm, et de Syph., 1884, pp. 332, 380. 

1) Twenty-seven cases of extra-genital chancre. (See Lavergne). 
Annales de Derm, et de Syph., 1890, p. 654. 

2) Case of vaccinal syphilis ; infant of 3 months, infected 

3) Its mother , chancre of right breast. 
Perroud, L. Lyons, France. 

Lyon Medical, 1869, III., p. 417. 

1) Three cases, chancre of lip, two in glass-blowers. 

2) Four cases, chancre of nipple in wet-nurses. 

3) Case, chancre of lip in wet-nurse. 
Peter. Berlin. 

Dermatolog. Soc. of Berlin, Dec. 1, 1S92. (Medical Press, Dec, 1S92). 

1) Had observed in Lassar's wards, during the past year, 20 cases extra- 
genital syphilis: upper lip, 8; lower lip, 4; mouth, 2 (from coitus per 
os); 1 each on neck, finger, lumbar region, thigh, and labium major in 
infant of 8 months, from its father, by using child's diaper as a towel. 

Dermatolog. Soc. of Berlin, Dec. 6, 1S92. (Le Mercredi Medical, Dec. 28, 
1892). 

2) Case, chancre left index finger in young man, auto-inoculated from a 
chancre on his penis. 

Petersen, O. V. St. Petersburg. Royal Alex. Hosp., Venereal Division. 
St. Petersb. Wochenschr. , 18S0, No. 47. 

1) Case, 2-year-old child, infected by dry-nurse. 



ANALYTICAL BIBLIOGRAPHY 345 

Vratsch., 1886, Nos. 23, 24. (Also in Monatsh. f. prakt. Derm., 1888, p. 307). 

2) Statement: in inland villages of Russia, 75 per cent, of infections are 
extra-genital. 

3) Eleven cases, chancre of lip, in young apprentices, 9 to 14 years of 
age, living in common. 

4) Case, chancre of cheek, from tooth inoculation. 

5) Case, chancre of tonsil, man, who infected 

6) His wife, chancre of. gum. 

7) Case, nurse, infected by nursling of above. 
Vratsch., No. 44, 18S9, p. 980. 

8) Case, chancre of left forefinger, man from bite. 

Vratsch., No. iS, 1890. (Monatsh. f. prakt. Derm., 1890, Vol. XI., p. 69). 

9) Case, chancre, mucous surface middle of upper lip. 
Vratsch., No. 49, 1891, p. 11 14. 

10) Case, chancre lower lip, man from a napkin. 
Petreni, M. 

Lo Speriment, Feb., 1871 (Giorn. ital. d. mal. ven.,etc, 1871, I., p. 238). 
Case, female, syphilis acquired by nursing. 
Petrini. Turin. 

II raccogl. med. Forli, 1850. (Gaz. des Hop., Paris, 1852, No. 5). 

1) Two cases, chancre, of nipple, nurses from nurslings, infecting 

2) Their two children and husbands. 
Petronius, A. Trajan. 

"De morbo Gallico," c. 22. (Cited by Loew, 1682, q. v.). 
Case, infection of a respectable matron, source unknown. 
Petry. Gratz. 

Ailgem. Wiener med. Zeit'g, 1859, V., No. 14. 

Epidemic from tattooing; nine soldiers victims, though only four 
were seen, inoculated from tattooer. (See Epidemics). 
Pettmann, P. B. Frankfort. 

Nov. Act Physico-Med. Act. Nat. Cur., 1767, III., Obs. 96, p. 497. (Gir- 

TANNER, No. 1323). 

Case, chancre of finger in a midwife. 
Pfluger. . Bern. 

Klin, monatsbl. f. Augenh., 1876. (Archiv f. Derm. u. Syph., 1876, p. 63S). 

1) Case, chancre both eyelids, left eye, man aged 72 years. 
Augenklinik in Bern, Bericht, 1877. (Archiv f. Derm. u. Syph., 1889, p. 

248). 

2) Case, chancre both eyelids, right eye, woman aged 59 years. 
Pick, F. J. Prague. 

Allg. Wiener med. Zeitung, 1880, XXV., p. 79. 

1) Case, chancre of ring finger, in a midwife. 
Allg. Wiener med. Zeitung, 1883. XXVIII., p. 18. 

2) Case, chancre of lower lip, in girl aged 22 years. 
(See also Balm, Lazansky, and Plumert). 

Piogey, Gerard. Paris. 

Soc. med. du 2me arrondissement de Paris, Seance May nth, 1854 (Clerc, 
" Traite prat, des mal. ven.," Paris, i860 p. 12S). 
Case reported by Arnal (q. v.). 

Pirandran. 

" De la syphilis des amygdales," These de Paris, 18S4. (Archiv f. Derm. 
u. Syph., 1889, p. 248). 
Case, chancre of tonsil. 

Pitha, F. von. Vienna. 

Wiener med. Presse, 1867, No. 14 (Cited by Jaffe, q. v.). 

Epidemic from circumcision; thirty boys infected by one operator. (See 
Epidemics). 



34 6 SYPHILIS INSONTIUM 



Pitton. 

Journ. des connais. med. chir., Dec, 1844 (Amer. Journ. of Syph. and 
Derm., Vol. I., p. 194). 
Two cases of supposed vaccino-syphilis. 
Plenck, J. J. 

" Doctrina de morbis venereis," Viennse, 1779, Vol. I., p. 154 (Roussel, 
" De la syph. tertiare,"i88i, p. 204). 
Case, 13-year-old girl, infected by nurse. 
Plinatus, I. St. Petersburg. 

Medizinskij Wjestnik, 1873, No. 19 (Monatsh. f. prakt. Derm., 1888 p. 310). 
Thirteen cases chancre of breast, from nurslings, in foundling asylum, 
from 1870 to 1873. 
Plouquet, W. G. Tubingen. Univ. Prof, of Medicine. 
" Literatura Medica Digesta," 1809, Vol. III., M-Z. 
Cites numerous references in literature, to syphilis insontium; under 
headings, obstetrix, nutrix infecta, propagata, per salivam infectam, 
oscula, pocula, vulnera, scarification em, etc. 
Plumert, A. Prague. Univ. Clin, for Skin dis. and Syph. (Prof. Pick). 
Allgem. Wiener med. Zeitung, 1879, Nos. 49, 50, 51. 

1) Four cases, chancre of breast, from lactation. (Obs. I -IV.). 

2) Case, chancre, upper lip, in woman ; her sister syphilitic ; infected by 
eating or drinking-ware. (Obs. V.). 

3) Case, chancre, upper lip, in man, abnormal exposure. (Obs. VI.). 

4) Case, chancre, lower lip, source unknown. (Obs. VII.). 

5) Case, chancre, right angle of mouth, in woman of 40 years, from pap- 
bag of an infant ; this infant infected about same time, chancre of 
chin, source unknown. (Obs. VIII. , IX.). 

6) Case, chancre of thumb, in midwife, professional exposure. (Obs. 
X.). 

7) Case, chancre, male breast, from scratch by older brother. (Obs. XI.). 
(All the above during year 1 8 78-79). 

Allgem. Wiener med. Zeitung, 1880, No. 4. 

8) Case, chancre of breast, from nursing strange infant. 
Poggio, R. H. 

Gazeta med. (?) (Lancet, London, April, 1850). 
Case, chancre of nipple, nurse from nursling. 
Poilroux, J. 

Journ. de med. et de chir. prat., Paris, 1841, XII., Art. 2337. 

Tatooing inoculation; operator the medium only, victim inoculated 
from another tattooed subject, through needle. 
Poincy, F. A. R. de. 

"Etude prat, sur la syph., infant, hered. et acquise." These de Paris, 
1877.* 

Poisson. Paris. r Hop. du Midi. (Service of Ricord). 
(Fournier "Etude sur la chancre ceph.," 1858). 

1) Four cases, chancre of lip. 

2) Case, chancre of foot. 

Polaillon. Paris. Hop. de la Pitie. 
La France med., 1881, I., p. 445. 

Case, chancre sole of foot, girl aged 15 years, in site of a wound made 
by a peg in a second-hand shoe. 

Polak, J. E. Vienna. Foundling Asylum. 

Wiener Rundschau, Nov., 1870, (Archiv f. Derm. u. Syph., 1S71, p. 446). 
Case, nurse infected by nursling. 

Poliataieff, P. St. Petersburg. 

Vratsch., iS89 ; No. 40. (Archiv f. Derm. u. Syph,, 1S91, p. 327). 



ANALYTICAL BLBLLOGRAPHY 347 

Epidemic of syphilis from cupping; eleven victims, chancre on the back 
from wet-cupping by a peasant woman. (See Epidemics). 
Polin, H. 

" Contrib. a 1' etude du role de la syph. dans la vaccinat.," Gaz. hebdom. 
de med. et de chir., Paris, 1882, XIX., p. 308). 
Of 471 vaccinated, 61 with success; among the latter 48 children were 
infected, presenting marks of syphilis, either in themselves or in their 
parents from their infection. 
Pollaesik, S. Buda-Pesth. Clinic of Dr. S. Rona. 

Orvosi Hetilap, 1890, No. 15 (Monatsh. f. prakt. Derm., Vol. X., 1890, 
p. 520). 
Multiple chancres after scabies. 
Pollis. 

Omodei's Annali universali di med., Apr., 1842.* 
Description of " Spirocolon." 
Pollock. 

Lancet, London, 1866, I., p. 424. 

Case, syphilis in child %*4 years old, possibly from vaccination. 
Polotebnoff, A. G. St. Petersburg. 

Trans, first St. Pet. Gov. sanit. meeting, 1875, Feb. 6, pp. 3-9. 

1) " Foundling home " prolific source of syphilis of peasantry, who take 
infants to nurse. 

2) Group of cases, chancre of nipple, infected in " foundling home." 

3) Great numbers of peasant women, infected by nursing or by taking 
"sucking horn" into mouth (Drs. Kanin, Roshtchinin, Stromberg, 
Rosoff, Thatkovsky). 

4) Eight cases, chancre of nipple, contracted in " foundling home;" on 
return home they syphilized upwards of 60 relatives and neighbors 
(Dr. Stein of Gdov. , q. v.). 

5) Case, chancre of nipple, wet-nurse, on return home infected own 
infant and husband (Dr. Sotchara, q. v.). 

6) Syphilis insontium spread by female servants (Drs. Sotchara, Ber- 
tei.s, and Alablskeff). 

Protoc. d. russ. syph. u. derm. Gesell., 1885, p. 27 (Archiv f. Derm. u. 
Syph., 1SS9, p. 249). 

7) Case, boy, infected probably from drinking-cup in school. 

8) Case, chancre, right tonsil, adult female. 

Poncelet. Bruxelles. 

Presse med. Beiges, 1884, No. 31. (Virch.-Hirsch Jahrb., 1884). 
Case, chancre, new-born infant, from mother's parts. 

Poncet. Lyons. Surgeon to Hotel-Dieu. 

Soc. de sci. med. de Lyon, Annales de Derm, et de Syph., 1881, p. 115. 

1) Case, chancre of nasal septum in a young girl. 

2) Case, chancre of gum, above a large molar tooth. 

Pontet, A. Paris. 

"De la syphilis infantile acquise." These de Paris, 1878. 

1) Case of Fournier's, Hotel-Dieu, 1866, chancre of vulva in a 7 weeks 
infant, from an infected sponge. (Obs. I., p. 10). , 

2) Case of Gueniot's, Hop. des Enfants-Assistes, infection per os of a 
6-year-old boy, from kissing another child (p. 14). 

3) Case of Fournier's, chancre of tongue, in an infant, who infected 
itself from its nurse, by its fingers. (Obs. II., 2 p. 15). 

4) Case of Archambault's, Hop. des Enfants-Malades, 1878, nurse in- 
fected at breast by nursling, own infant acquires chancre of lip. 
(Obs. III., p. 16). 

5) Case of C. Pail's, notes by Letulle, chancre of lip, in boy of 6 years; 
his mother was syphilitic. (Obs. VIII., p. 32). 



PERCENTAGE 

Males Females 


Total 


35-40 44. 
6.49 7.51 
0.024 0.024 
5.27 2.62 


78.50 
14.00 
0.048 
7.89. 



34S SYPHILIS INSONTIUM 



Pontoppidan. Copenhagen. 

Archiv f. Derm. u. Syph., 1882, p. 201. 
Upon the subject of " Yaws." 
Poore. London. Brompton Hospital. 
Lancet, London, Jan. 10, 1880. 
Case, chancre beneath right eye. 
Popoff, K. D. Kursk, South Russia. 

Proceed, of Kursk Med. Council for 1884. 

1) Of 338 syphilitic peasants in Kursk township, only 54 were infected 
by coitus, 44 inherited and 240 (85 per cent.) from family infection. 

Trans. 2d gen. meeting of med. men at Moscow, 1887, Vol. II. , Sec. vi., 
pp. 106-117. (See also Monatsh. f. prakt. Derm., 1887, p. 856). 

2) During 1884-5, medical men in Kursk registered 11,749 syphilitics, 
(5038 males, 671 1 females; of these 2231 children under 5 years). 

Mode of infection ascertained in about one-third of cases as follows : 

NUMBERS. 

Males Females Total 
Innocent contact, 1400 1808 3208 
Hereditary, 267 309 576 

Vaccination, 11 2 

Coitus, 217 108 325 

3) Infection, from members of patients' own family, 1229; from neigh- 
bors, 103; from suckling infants, 50; in military service, 21; from 
domestic servants, 19; from dry-nurses, 15; from using a stranger's 
utensils, 11 ; from lodgers, 4; from kissing, 3 ; from a beggar woman, 
1 ; at school, 1 ; from a cigarette, 1 ; from a publican, 1 ; at a public 
bath, 1. 

" Erster Vers, einer Erfors. ii. d. Verbreit. d. Syph. in Kursk'schen Kreise 
nach d. Kartensystem f. d. J. 188S" (Archiv f. Derm. u. Syph., 18S9, 
p. 249)- 

4) In government Kursk, 85 per cent, extra-genital infection. 

5) In government Wladimir, 91.3 per cent, extra-genital; of these, infec- 
tion per os, 63.9; hereditary, 7.7 ; and nursing, 2.4 per cent. 

Poray-Koschitz, W. Charkow, Russia. Univ. Clinic for Syphilis. 

Sitzungsb. der med. Gesellsch. zu Charkow, 1875, Moscow, Med. Gaz., 
1875, No. 8. (Archiv f. Derm, und Syph., 1876, p. 660). 

1) Three cases, chancre of lip, from syphilitic fellow-workman, by pass- 
ing the same thread through the lips of each of them. 

Zdorowje, 1881, Vol. VII. (Archiv f. Derm. u. Syph. 1889, p. 249). 

2) Domestic epidemic of syphilis ; eight victims. 
Russkaja Medicyna, 1SS5, No. 48. 

3) Case, chancre by tooth inoculation. 

4) Case, chancre of the fauces. 

Monograph on Topography of Syphilitic Chancre, 1890, p. 149. Also in 
Wiestnik sud. med. y hyg. , Oct. 9, 1SS9. (Archiv f. Derm. u. Syph., 
1890, p. 929). 

5) Forty-eight cases extra-genital chancre during 1870-1S90 (lip, 3; fore- 
head, 1 ; tongue, 3; pharynx, 4; buccal cavity, 16; breast, 7; trunk, 1 ; 
arm, 2 ; finger, 1). 

6) Case, chancre of foreskin, in Jewish boy of 15 months, from circum- 
cision. 

7) Case, chancre right tonsil, in 6-year-old sister of above. 

8) Case, chancre of lower lip, man 23, from kissing a gentleman friend. 

9) Case, chancre lower lip, boy of 3 years, source unknown. 

10) Case, chancre lower lip, in Jewish virgin of 15, from brother. 

11) Case, chancre lower lip in married woman of 28, source obscure. 

12) Case, chancre lower lip, in boy of 2, source obscure; infected 

13) His sister of 6 years through the mouth. 

. 14) Case, chancre upper lip, in boy of 10, source unknown. 






ANALYTICAL BIBLIOGRAPHY 349 

15) Case, chancre both tonsils, boy of 3, from maid-servant with labial 
ulcers. 

16) Case, chancre both tonsils in priest of 40, source obscure. 

17) Case, chancre hard palate, in girl of 7 years from mother. 

18) Case, chancre forehead, in sculptor of 25, source unknown. 

19) Case, chancre of areola of breast, external to nipple, in Jewess of 23, 
from nursing syphilitic infant of her cook, having too much milk 
for her own infant. 

20) Case, chancre left nipple, from suckling her own child, which was 
occasionally fed from mouth to mouth by a syphilitic maid-servant. 

21) Case, chancre left nipple, in lady of 29, from suckling own child, 
which was vaccinated when 9 months old, and contracted chancre at 
site of vaccination. 

22) Case, chancre both nipples, from suckling own child which was 
vaccinated when 4 months old and contracted chancres at sites of 
vaccination. 

23) Case, chancre left areola, in young wet-nurse from nursling. 

24) Case, chancre both areolae, in married woman of 19, wet-nurse from 
nursling. 

25) Case, chancre right thumb, about nail, in physician of 30, while 
reducing apara-phymosis in which there was chancre within prepucial 
sac. 

26) Case, chancre back of hand, in medical student, from handling 
syphilitic patients. 

Medycyna, 1890, Nos. 53, 55, 56 (Journ. of Laryng. and Rhinol., London, 
Nov., 1890, p. 463, and London Med. Rec, 1890, p. 396). 

27) Case, chancre upper lip, man aged 29 years. 

28) Case, chancre lower lip, lad aged 16 years, who infected 

29) His brother, aged 9, chancre buccal cavity. 

30) Case, chancre, inner surface right cheek, man aged 28 years. 

31) Case, chancre of fauces, man aged 35 years. 

32) Case, chancre of fauces, boy aged 3, son of above, from playmate. 

33) Case, chancre of fauces, little sister of above, from him. 

34) Case, chancre of fauces, mother of above children. 

35) Case, chancre, left tonsil, from spoon of syphilitic comrade. 
Portal, A. Paris. 

" Obs. sur 1. nat. et traitem. d. 1. phthisie pulm.," 1792. 
A prince inoculated when 19 months old, by a nurse. 
Porter, R. 

British med. Journ., 1887, II., p. 1277. 

Case, two chancres on forearm from tattooing; infection from operator, 
by use of saliva. 
Porter, W. H. Dublin. Prof, of Surgery, Royal College of Surgeons of 
Ireland. 
Dublin Quart. Journ. of Med. Sci. 1857, XXIII. , pp. 88, 257; XXIV., pp. 
75, 287. 
Case, chancre of tonsil, in woman from husband (reported by Mr. Pratt 
111 Dublin Med. Press, Oct. 5, 1853). 

Pospelow. A. Moscow. Univ. Prof, and Chief of Mjassnitzky Hospital. 
Protoc. (1. conf. d. Aerzte d. Mjass. Krankenh. in Moskau/ 18 78. 

1) Case, chancre of thumb, man 54 years old. 
Protoc. d. phys. mod. (resells, an d. Univ. Moskau, 1881, I. 

2 Case, chancre of tongue, shoemaker, aged 28 years. 
Protoc. d. GeseDsch. russ. Aerzte in Moskau., Apr. 4, 1881. 

3) Case, chancre of chin, girl aged 18 years, from kiss. 
Archiv f. Derm. u. Syph., 1889, pp. 59, 217. 

4) Statistics: from 1878 to 1887, extra-genital chancre. 198 cases; breast, 
69 ; lip, 49; fauces, 46; finger, 5 ; eyelids, 3 ; tongue, 3 ; gums, 1 ; nose, 
1 ; chin, 1 ; arm, 1 ; buttocks, 10; anus, 5; lower extremities, 4. 



35° SYPHILIS INSONTIUM 

5) Of the 69 breast cases, 56 were from hereditarily syphilitic infants and 
13 from own nurslings previously infected. 

6) Case, chancre of gum, clarionet player, from common use of instru- 
ment (p. 76). 

7) Case, chancre of tongue, shoemaker, from shoepegs (p. 77). 

8) Case, chancre of tongue, in 34-year-old female, nurse from nursling 
(P- 78). 

9) Case, chancre of fauces, female from another with chancre on lip 
(p. 88). 

to) Case, chancre of fauces, virgo intacta, iS years, from ner mother, 
infected with a chancre of the tonsil (p. 88). 

11) Case, chancre of fauces, girl 10 years of age, from kissing (p. 89). 

12) Two cases, chancre of fauces, nurses from nurslings (pp. 89, 90). 

13) Case, chancre of fauces, from common use of wooden spoon (p. 89). 

14) Four cases, chancre of fauces, girls 14 and 15 years of age (p. 89). 

15) Case, chancre right upper eyelid, coal dealer, aged 33 years (p. 228). 
ib) Case, chancre inner angle of eyelid, rubbing with a soiled apron 

(p. 229). 

17) Case, chancre upper right eyelid, from application of tongue by a 
syphilitic (p. 229). 

18) Case, chancre of nose, from a towel, in man of 26 years (p. 229). 

19) Case, chancre of chin, female, sleeping with a syphilitic (p. 230). 

20) Case, chancre of finger, musician, aged 45 years (p. 230). 

21) Two cases, chancre of ringer, midwives (p. 231). 
Posselt, C. Munich. Univ. Docent in Syphil. 

Two cases, chancre of lip. (See Walter). 
Post, Abner. Boston. 

Boston Med. and Surg. Journ., Feb. 4, 1892, p. 118. 
Saw six cases of non-venereal contagion in two weeks. 
Pottcher, J. F. Konigsberg. 

" Bemerk. iiber med. Verf. Hosp. und Kurarten," Konigsberg, 1800. 
(Dieterich, "Die Krankheitsfamilie Syphilis," Miinchen, 1842, Bd., I., 

P- re- 
statements (with or without cases) as to the contagion of secondary 
syphilis, and the not infrequent infection of families (pp. 86, 91). 

Poumeau-Delille, A. 

"De la transmission de la syph. par la vaccination." These de Paris, 
1869, 48, p. 42. 
(No original cases, only review of Cerioli, Wegeler, Hubner, epidemic 
in Lupara, Lecocq Viennois, epidemic in Rivalta, Trousseau, 
Devergie, Herard, Sebastian, Depaul, Millard, epidemic in Lot, 
Closmadeuc and Denis, Schule (Depaul), Guerin, q. v.). 

Pratt. 

Dublin Med. Press, Oct. 5, 1853. (Cited by Porter, q. v.). 
Case, chancre of tonsil, woman from husband. 

Prehn. 

Pfaff's Mittheilungen aus d. Gebiete d. Med. Chir. u. Pharm., Kiel, 1833, 

P- 47i- 
Epidemic from a wayfarer, in 1832, who put up at six places, en route, 
sleeping and eating in company; a number were infected. (See 
Epidemics). 

Prettyman, J. S. Jr. 

Med. Record, New York, 1886, XXX., p. 516. 
Case of supposed vaccino- syphilis. 

Prewitt, T. F. St. Louis, U. S. A. 

St. Louis Courier of Med., 1881, VI., p. 308. 

Case, chancre of the nose in a pregnant woman. 



ANALYTICAL BIBLIOGRAPHY 35 1 

Price, D. Margate, England. 

Lancet, London, Aug. 1S46, p. 197. 
Two cases, chancre of nipple, nurse from nursling; one of them infects 
her own nursing child and her husband. 

Price, J. H. 

New York Med. Monthly, 1886-S7, I., pp. 97-101. 

1) Infection of father, mother and three little children, source unknown. 

2) Statement: has seen several cases, chancre of lip, among smokers. 

3) Case, chancre of lip, young woman, from kissing. (Gross). 

4) Fifteen women, 9 children, 10 men, infected through a midwife 
(Gross). 

5) Two cases, chancre of finger, cook and chambermaid. (Marion-Sims). 

6) Four children infected by their mother, towels and wash bowls (?) 
Profeta, G. Palermo. Univ. Prof, of Skin Diseases. 

" Sulla sifilide par allattamento," Firenze, 1869 (work not accessible). 
" Trattato pratico delle malattie veneree," Palermo, 1S88. 

1) Case, infection by tooth-inoculation (p. 413). 

2) Case, five chancres of cheek, from a bite (p. 413). 

3) Infection of fourteen persons in one family from common utensils 
(p. 417). 

4) Cases of Fallopius, and Marc, q. v. (p. 417). 

5) Mention of cases, from common use of tobacco-pipes (p. 418). 

6) Mention of syphilis transmitted to children by means of bread, etc. 

7) Case, chancre between fingers, youth with scabies, through itch-mites 
(p. 4iS). 

8) Case, chancre .of nipple in a male (p. 424). 

9) Case, chancre of scalp from a comb (p. 425). 

10) Case, chancre, dorsum of foot, through shoe (p. 425). 
Proksch, J. K. Vienna. 

"Die Litteratur iiber die venerischen Krankheiten." 3 volumes, Bonn, 

1889, 1890, 1891. 
A complete bibliography of syphilis to the end of 1S89. 
Protopopoff, P. S. 

Vratsch., 1880, I., p. 139 (Archiv f. Derm. u. Syph., 1889, p. 250). 

Case, chancre upper lip, in 24-year-old man, excised by Protopopoff 
for microscopial study. 

Protzek, E. V. 

" Ueber extragen. primaraffecte,'' etc. Dissert., Breslau, 1891 (Archiv f. 
Derm. u. Syph., 1891, p. 788). 
Extra-genital chancres, Breslau Derm. Clinic, 1879-90; largest number 
on lip, finger, 5 (2 in midwives) ; cheek, 3; eyelid, 2; tongue, 1 ; tonsil, 
1 ; ear, 1 ; several on the breast. 
Puche, P. Paris. Hop. du Midi. Surgeon. 

(Cited by Fournier, " Leeons sur la chancre," 1858, p. 240). 

1) Cases, chancres, upper lip, 13; lower lip, 5; tongue, 5; tongue and 
upper lip, 1 ; lower lip and index finger, 1 ; labial, 1 ; naso-labiai 
furrow, 1 ; face, 1. 

2) Case, chancre, Irom prison cot vacated by prostitute (see Acton). 
L'Union med., Paris, 1853, No. 10. 

3) Case, chancre, left shoulder. 

Pujol. Paris. 

"De l'influence des malad. du nez, et de la gorge, sur la production des 
mal. de l'oreille," Paris, 1881. 
Two cases, Eustachian infection in a youth, and old lady, aged 63 (p. 131). 

Purdon, H. S. Belfast. Physician to Skin Hospital. 
Med. Press and Circular, Jan. 29, 1873. 
Case of vaccino-syphilis (see Scott). 



35 2 SYPHILIS INSONTIUM 



Putegnat. Luneville. 

"Hist, et therap. de la syph. des Nouv.-nes," Paris, 1854. 

1) Case, nurse infected by nursling. 

2) Case, nursling infected by own mother (p. 126). 

3) Two nurses infected by same nursling (p. 130). 
Quain, R. London, Univ. College Hospital. 

Med. Times and Gaz., 1859 — Mason, q. v. (also Brit. Med. Journ., i860, I., 

P- 145). 
Three cases, chancre of lip, mistaken for epithelioma. 

Quarenghi. Torre de Busi. 

(Cited by Viennois from Adelasio "Syph. vaccin. com. a l'Acad.," Paris, 
1865, p. 303). 
Epidemic from vaccination, near Bergamo (see Adelasio). 
Quinquaud, Ch. E. 

Model in Musee de l'Hop. St. Louis (Annales de Derm, et de Syph., Vol. 
III., Aug., 1892, p. 944). 

1) Case, chancre of breast. 

Model in Musee de l'Hop. St. Louis (Annales de Derm, et de Syph., Vol. 
III., Aug., 1892, p. 945). 

2) Case, double chancre of the tongue. 
Quinquaud, Ch. E. and Nicolle. 

Annales de Derm, et de Syph., Vol. III., 1892, pp. 1228-1243. 

1) Fourteen cases, chancre of lip (11 lower, 3 upper); cause given in only 
one case, that of a man of 25 years, chancre lower lip from smoking 
brother's pipe. 

2) Case, chancre left breast in female of 18, no cause given. 

3) Case', chancre right tonsil in female of 21, no cause given. 

4) Case, chancre over Scarpa's triangle in female of 21, cause unknown. 

5) Case, chancre right naso-labial furrow and right temple in man of 
22, cause unknown. 

6) Case, chancre tip of tongue in female of 20, no cause stated. 

7) Case, chancre of chin in man of 26, cause unknown. 

8) Case, chancre right forearm in woman of 36, cause unknown. 
Quitzmann. 

" Deutsche Briefe iiber den Orient/' Lancereaux, " Traite," etc., p. 42. 

Notice of " Spirocolon." 
Rabinovitch, M. F. 

Provincial Med. Journ., April, 1892, p. 211. 

Case, chancre, upper lip. 

Rabitsch, J. Cairo. 

Gazz. d. ospit., Milano, 18S3, p. 218 (Berlin, klin. Wochenschr., 1887, No. 
17, p. 306). 
Case, chancre, left tonsil, in man aged 42 years. 

Rabl, J. Vienna. 

Semaine med. , 1S89, p. 23. 

Case, nurse infected by nursling. 

Rafinesque, G. 

" Contribution a l'etude de la syphilis infantile,'' Archiv. de toxicologie, 

1874, P- 333- 
Twenty-seven cases of syphilis in infants, after birth ; mother, father, or 
both syphilitic. 

Randall, B. A. Philadelphia. 

(Personal communication to De Beck, and by him to author). 
Case, chancre of eyelid. 

Ranke. Groningen. 

Med.-chirurg. Centralblatt, Wien, 1S79, XIV., p. 374. 



ANALYTICAL BIBLLOGRAPHY 353 

Case, nurse-mother, chancre of nipple, from own nursling (exception to 
Colles' law). 
Rasori, E. Rome. Clin, for Derm, and Syph. (Prof. Manassei). 
Gaz. d. Osp. d. Milano, 1883, IV., p. 653. 

1) Case, chancre of external ear. 

Deutsche medicin. Zeit'g, 1885, I., p. 137 (Archiv f. Derm. u. Syph., 1888, 
p. 17). 

2) Case, chancre of nostril. 

(See also Ravogli and Rasori). 
Rassler, A. Kiel. 

Beitrag zur Aetiologie des Morbus Gallicus, Inaug. Dissert., Kiel, 1S91 
(Archiv f. Derm. u. Syph., 1892, p. 155). 

1) Statistics of 12 years: among 630 cases of syphilis, there were 34 
cases (5.3 per cent.), of extra-genital chancre. 

2) Chancie of lip, 23: breast, 3; tongue, 2; genitals (without coitus) 3. 
Raulin, J. Paris. Physician to the King. 

" Observ. de med " Paris, 1754 (p. 250) (Rollet, " Traite des mal. 

ven.," 1866, p. 455. 
Epidemic of syphilis at Nerac, 1751, known as Pian de Nerac, beginning 
from lactation ; more than forty nurses and nurslings affected, and 
later members of their families. (See Epidemics). 

Ravel. 

(Cited by Bouchut, "Traite des mal. d. nouv.-nes," 5th Edit., 1867, p. 

1057). 
Case, nurse infected by nursling; 5,000 fr. for damages. 

Ravogli, A. Cincinnati, U. S. A. 

Phila. med. News, Vol. LXL, 1892, p. 80. 

1) Case, chancre beneath nail of right 3d finger, cause unknown. 

2) Case, chancre of right thumb in a man, cause not stated. 

Ravogli, A. and Rasori, E. Rome. Univ. Clin, for Derm, and Syph. (Prof. 
Manassei). 
Giorn. ital. d. mal. ven., etc., iSSo, p. 384. 

1) Two cases, chancre of lip. 

2) Case, chancre of breast, nurse from nursling. 

3) Two cases, infection of glass-blowers. 

Raye, Alph. 

"Schanker an mehreren Stellen des Korpers," etc. Presse med. Beiges 
Bruxelles, 1S58, No. 28.* 

Rayer. Paris. Court-Physician. 

Gaz. med., 1850. (Reported by Bouchut, q. v.). 

1) Two cases, nurses from nurslings. 

2) Case, young virgin, syphilitic from room-mate. (See Lancereaux). 

Raynaud, M. 

(Personal communication to Lancereaux, q. v. 1 )* 
Case, Eustachian-sound inoculation, 1863. 

Razumoff, V. J. Moscow. 

Trans. 2d gen. meeting of Russ. med. men at Moscow, 1887, Vol. II., 
Sec. vi., pp. 59, 62. 

1) Statistics: among R95 wet-nurses examined, 179(20 per cent.) were 
syphilitic; among them, 

2) Case, chancre of tonsil. 

3) Three cases, chancre of breast, nurses from nurslings. 

Redner. 

Verhand. der deutsch. derm. Gesell., Sept. 17-19, 1891 (Monatsh. f. prakt. 
Derm., Vol. XV., 1892, p. 135). 
Case, chancre lower lip. 

24 



354 SYPHILIS INSONTIUM 

Regoby, P. Paris. 

" De la syphilis chez les personnes agies," These de Paris, 1887. (Annales 
de Derm, et de Syph., Paris, 1889, Vol. X., p. 168). 

1) Case, chancre of chin, in man 66 years old (service of Tillaux) 
' (P- 21). 

2) Case, chancre lower lip, in woman 61 years old (service of Martineau) 
(P- 5i). 

Reiche. 

(Cited by Oesterlen, q. v., "Ven. Contagien," 1836, p. too). 

Domestic infection ; family of man, wife, nursling and two-year-old 
child, with recent syphilis ; wife had sores on nipples. 
Reichebach. Gottingen. 

Mittheil. aus d. syph. Abtheil. d. Ernst- Aug. Hosp. z. Gottingen, 1889, 
p. 14. 

1) Nine cases, chancre of lip. 

2) Case, chancre of breast, from lactation. 

Reid. 

(See Plouquet "Liter. Med. Digest," 1809). 
Diseases of the army and Navy. 
Renard, L. Nevers, France. 

L'Union Med., 1862, XVI., p. 578. 
Case, chancre of tonsil in newly married woman; husband mucous 
patches in mouth. 
Renault, Alex. 
* Annales de Derm, et de Syph., Vol. III., 1892, p. 1275. 
Case, chancre right side neck, in girl of 16, from a kiss. 
Reshetnikoff, I. P. St. Petersburg. 

Vratsch., No. 5, 1892, p. 118 (St. Louis Med. and Surg. Journ., June, 1892). 
Case, chancre back of neck in man from wet-cupping by a Finnish, 
woman with " whitish crust on her lips.'' 
Reumont, A. Aachen. 

"Syphilis und Tabes," 1SS1, p. 63, Obs. XL 
Case, chancre of lip from husband. 
Reynier. Paris. Hop. St. Louis. 
(Reported by Sardon, q. v.). 

Case, probable chancre (Fournier) right tonsil. 
Reynolds, H. J. Chicago. 

Philadelphia, Med. Times, 1888, XVIII., p. 321. 

Case, chancre left tonsil, in man of 45 years from unnatural practices.. 
Rhodius, J. Padua. 

" Observ. med. cent, tres.," Patavia, 1657 (Girtanner, p. 234). 
Infection by lactation (Plouquet). 
Richerand. Paris. 

(Cited by Clerc, " Traite prat, des mal. ven.," Paris, 1S66, p. 15). 
Case, infection per os from a pen held in the mouth. 
Richet. Paris. 

(Cited by Ricord, q. v., L'Union Med., Paris, 1S51, p. 201). 
Case, an infant infected by supporting it in the hand. 

Richon. Hop. Militaire de Belfort. 

Gaz. des Hop., 1881, No. 78, p. 620. 

Case, chancre lower eyelid from kissing, in man of 22 years. 

Ricord, P. Paris. 

Traite pratique des maladies veneriennes," Paris, 1S38. 

1) Statistics: among 588 chancres, 24 extra-genital; lips, 7; fauces, 3; 
various locations, 14 (pp. 525, 526). 

2) Case, chancre of fauces, from drinking-glass (p. 500). 






ANALYTICAL BIBLIOGRAPHY ^55 

(Cited by Acton, q. v., "A complete treatise on ven. dis.," London, 1841, 
p. 227). 

3) Case, chancre after venesection. 

Annal. d'oculistique, Vol. XXIV., 1S50, p. 233. 

4) Case, chancre lower eyelid, lawyer, from rubbing eye with his soiled 
finger. 

" Clinique iconographique," Paris, 1863. Amer. Edit., Philadelphia, 
1852. 

5) Case, chancre of right thumb (plate 15, fig. 3). 

" Lettres sur la syphilis,'' Paris, 1S63 (also in L'Union Med., 1850, No. io, 
p. 145; 1851, No. ii, p. 131). 

6) Case, chancre of finger in physician (p. 65). 

7) Case, chancre of left cheek in medical student (p. 88). 

8) Case, chancre upon the sinciput (p. 88). 

9) Case, chancre of eyelid (p. 88). 

10) Three cases, chancre of lip (pp. 89, 1S3, 199). 

11) Two cases, chancre of nipple, one in a man from contact with lips of 
woman ; second from husband, breast-drawing. 

12) Case, infection, child from contact with diseased parts (p. 201) 
(Richet). 

" De la syphilisation et de la contag. des accid. second, de la syph.," 
communication a l'Acad. nationale de med., Paris, 1853. 

13) Two cases, chancre upper eyelid (p. 335). 

14) Case, infection of a child, source unknown (p. 337). 
Bull, de l'Acad. de med., 1S53. 

15) Case, chancre of eyelid (Gubler) (p. 284). 

16) Case, chancre of back (p. 303). 

" Du chancre de la bouche et son diagnostic difT.," Gaz. des Hop., Paris, 
1858, XXXI. 

17) Nine cases, chancre of lip (pp. 503, 504). 

18) Case, chancre of lip, female from pen used by syphilitic son (p. 503). 
" Legons sur la transm. de la syph. par la vaccin.," Gaz. des Hop., Paris, 

1862. 

19) Case, chancre left arm, female (Trousseau), Xo. 7, p. 25. 

20) Case, chancre lower eyelid, Xo. 12, p. 46. 

21) Case, chancre of forearm from vaccination, Xo. 11, p. 41. 

22) Case, chancre of lip from kissing, Xo. 11, p. 42. 

23) Infection of nine children after circumcision, Xo. 11, p. 42. 

Ricordi, A. Milan. Osped, Magg. and Instit. di S. Corona. 
"Sifilide da allattamento," Milano, 1865. 

1) Infection of 4 or 5 nurses, from breast-drawing, they infecting own 
nurslings (p. 33). 

2) Case, chancre of nipple, from applying dressing from a syphilitic 
woman (p. 34). 

3) Case, infection from vaccination (p. 37). 

4) Epidemic at Casorezzo: 23 infected, starting from a hereditarily syph- 
ilitic child; nurslings, 10; nurses, S; spoon-feeding, 3 (p. 49). 

5) Epidemic at Ubolclo: i5 infected; nurses, 9; nurslings, 9 (p. 65). 

6) Epidemic at Marcallo, 16 infected (p. 78). 
71 Epidemic at Rovello, 14 infected (p. 78). 

8) Case, chancre of nipple, nurse from nursling, infecting 

9) Infant, chancre of mouth, infecting 

10) Nurse-mother, chancre of nipple, from nursling (p. S6). 

11) Case, infection, source unknown, infecting 

12) Mother, chancre of nipple, from nursing (p. S7). 

13) Case, chancre of lip, nursling from above nurse (p. 87). 

14) Case, chancre of nipple, nurse from rfbove nursling (p. S7). 

15) Case, chancre of nipple, nurse from nursling (p. 88). 

16) Case, chancre of tongue, nursling from nurse (p. 88). 



35 6 SYPHILIS INSONTIUM 

Ridley, H. London. 

11 Observ. med. pract.," 1703. (Cited by Plouquet under "per mammas, 
lactationem, vice versa.") 
Infection by lactation. 
Riedlin, V. Ulm. 

" Linearum med. per singul. mens, contin. duct.,'' 1695-1702 (Girtanner, 

p. 297). ... 

"Lues venerea a pariente infecta in obstetricem translata" (III., Feb., 
Obs. 12). 
Righter, W. H. Topeka, Kansas. Prof. Gen. Urin. dis. and Derm., Kan. 
Med. Coll. 
Kansas Medical Journal, 1890, Vol. II., p. 648. 

Case, chancre, external ear, from application of court-plaster to a burn. 
Rigler. 

11 Die Turkei und deren Bewohner," Wien, 1852. 
Syphilis, "Aleppo Evil," etc. 
Rinecker, F. von. Wiirzburg. 

Verhandl. d. phys.-med. Gesellsch. in Wiirzburg, 1852, 1., p. 117; III., 375. 

1) Case, dry-nurse, aged 20, infected by infant. 

Wiener med. Presse, 1877, No. 42, p. 1359 (also Archiv f. Derm. u. Syph., 
1878, p. 265). 

2) Case, vaccino-syphilis, chancre, left upper arm, in a child born with 
hereditary syphilis. 

Ring, H. W. New Haven, Conn. 

New York Med. Record, Vol. XLII., 1892, p. 535. 

Case, chancre, right upper eyelid, in 17-year-old girl, cause not stated. 
Ritter, Paul. (Dentist). 

Deutsch. Monataschr. f. Zahnheilk., X., Jahrg., Feb. (Monatsh. f. prakt. 
Derm., Vol. XV., 1892, p. 316). 
Syphilitic affections of the mouth and the transmission of syphilis by 
operations upon the mouth and upon the teeth. 
Riverius, L. Montpellier. 

''Observ. med. et curat, insignes," Paris, 1646 (Cent. L, 91 ; II. 95 ; IV., 91). 
(Plouquet). 
Nurse infected by nursling, etc. ; three observations. 
Rizat, A. Paris. 

" Manuel pratique des maladies veneriennes," Paris, 1SS1. 

1) Case, chancre of lip, infection through cigar-guillotine, used just pre- 
viously to cut cigar, moistened in another's mouth (p. 68). 

2) Three cases, chancre of lip (lower 2, upper 1) (pp. 66, 68, 69). 

3) Case, chancre of chin (p. 73). 

4) Case, chancre of nucha, from carrying woman on shoulders (p. 77). 

5) Three cases, chancre of fingers (p. 78). 

6) Case, chancre of abdomen, from contact (service of Mauriac) (p. Si). 

7) Case, infection, nurse from nursling (p. 248). 
Annales de Derm, et de Syph., 1SS5, p. 115. 

8) Case, chancre of both tonsils. 

Rizzi, M. 

Gazz. med. di Milano, April, 1S46, No. 14. 
Case of lactation syphilis. 

Robbins, H. A. Washington, U. S. A. 

Medical News, Phiia., March 5, 1S92, pp. 263, 264. 

1) Case, chancre of hand, in girl of 7 years, from sucking wound by 
uncle with mucous patches. 

2) Case of circumcision syphilis ; mucous patches in mouth of rabbi. 

3) Several cases, infection from razors in shaving. 

4) Case, infection from bite of a man. 



ANALYTICAL BIBLIOGRAPHY 357 

Robert. 

Annates de Derm, et de Syph.. 1879, p. 417. 

Tattooing inoculation ; three soldiers from same operator. 
Robert, A. Paris. Hop. Beanjon. 

Two women, grand-mother, aged 70, and aunt of an infant, infected by 
the latter. (See Castelnau). 
Robert, Melchoir. Marseilles. (Ex-Interne Hop. du Midi, Paris). 
Traite des malad. verier., Paris, 1S53, p. 192. 

1) Statistics: among 202 chancres in service of Ricord, 25 extra-genital; 
lip, 7; chin, 6; tongue, 1; gum, 1; eyelid, 1; cheek, 1; forehead, 1; 
finger, 1; anus, 4; region of trochanters, 3. 

Xouveau Traite des mal. ven., Paris, 1S61, p. 321. 

2) Case, chancre external angle of eye. 
L'L nion med., Paris, 1S62, Xo. 47, p. 150. 

3) Review of vaccino-syphilis ; statistics of 219 collected cases. 
Robert, P. Montrejeau. 

Archiv. de Tocologie, 1S74, I., p. 756. 

Case, syphilis acquired through vaccination, chancres at points of 
insertion. 
Robinson, Edmund. Birmingham, England. Public Vaccinator. 
"Vaccino-syphilis," Lancet, London, 1S73, !•> P- 3 21 - 
Cases of supposed chancre at site of vaccination, but patients previously 
syphilitic. 

Robinson, F. 

British Med. Journ., 1S82, II., p. 632. 
Case of infection from tattooing. 

Robinson, T. London. St. John's Hospital. 

" Diagnosis and Treatment of Syphilis," London, 1S86, p. 29. 

1) Case, chancre "penis, from use of a foul scalpel in phymosis operation 
6-year-old boy. 

2) Case, chancre lower lip, cashier of a shop, through coin held in 
mouth. 

Roche (fils). Strasbourg. 

Journ. des connais. med. chir., Feb. 16, 1S51 (Ann. d. mal. d. la peau, 
1850-51, p- 194)- 

1) Three cases, chancre of nipple, nurses from nurslings (pp. 95-96). 

2) Case, chancre nipple, nurse from nursling, infecting her three 
daughters, 15 months, 4 years and 15 years of age (p. 96). 

3) Case, chancre nipple, nurse from nursling, infecting her child of 18 
months, and her sister, of iy 2 years (p. 96). 

4) Case, infection, nurse from nursling. 

Roddick, T. G. Montreal. Prof. Clin. Surgery, McGill University. 
Canada med. and Surg. Journ., 1880, VIII. 

1) Case, chancre lower lip, A. B., 27 years, from smoking pipe of 
syphilitic (p. 4-6). 

2) Case, chancre left nipple, woman of 27 years (p. 487). 

3) Case, chancre of neck, from a bite (p. 4S8). 

4) Case, chancre upper lip, from kissing, female of 30 (p. 4S9). 

5) Case, chancre right tonsil, from common use of spoon, woman of 42 
(p. 490). 

Montreal med. Journ.. [888, XVII., Xo. 2, p. 93. 

6) Case, chancre of gum, in married lady of 30, by forceps in extraction 
of a tooth. 

7) Case, chancre forehead, from scratch, during altercation with a man 
having syphilis. 

S) Case, chancre lower lip, glass-blower, fellow-workman syphilitic. 
9) Case, chancre palmar surface of wrist, washerwoman's daughter. 



35 8 SYPHILIS INSONTIUM 

10) Case, chancre dorsum of penis, midway between glans and root in a 
young boy, probably from watercloset. 
Rodet. Lyons. Surgeon-in-Chief, Hosp. de l'Antiquaille. 
Gaz. med. d. Lyon, May 5, 1862. 

1) Case, re-infection, chancre of lip (reported also by Diday). 
Gaz. med. d. Lyon, Jan. 16, 1865, p. 35. 

2) Case, infection from vaccination. 

3) Case, infection, nurse from same nursling, vaccinifer. 
Roger, H. Paris. Hop. des Enfants. 

" De la syphilis chez des enfants,'' L'Union med., Paris, 1863 (and Gaz. 
des Hop., 1863, Nos. 118, 119). 

1) Case, infection of a child by its mother (p. 5, No. 118). 

2) Case, chancre upper lip in child of 2 years, from kissing its syphilitic 
mother who had a chancre of the lower lip (p. 7, No. 118). 

3) Case, infection of a child of 11 months, from contact, dry-nurse (p. 
23, No. 119). 

" Etude clin. d. 1. syph. infant.," Paris, 1864. 

4) Case, infection, nurse from nursling, producing 

5) Case, infection, nursling from nurse (p. 91). 

With Depaul, q. v., Bull, de l'Acad. de med. de Paris, XXXI., p. 888. 

6) Epidemic, of vaccino-syphilis at Morbihan ; 44 infected. (See Epi- 
demics). 

Rognetta. Paris. Hotel-Dieu. (Service of Dupuytren). 

Revue med., 1833 (1832 ?), II., p. 383 (Cited by Yvaren, "Metamorph. de 
ia syph.," Paris, 1854, p. 138). 
Case, chancre of breast and eyelid, from nursling. (See Dupuytren). 

Rone, G. H. Baltimore, United States. 

Archives of Dermatology, New York, 1S78, p. 217. 

1) Case, chancre of nose, man 22, from bite. (See Brinton). 
Chicago Med. Journ. and Exam., July, 1878. 

2) Case, chancre, tip of tongue, from lead pencil. 

Rollet, J. Lyons. Hosp. de l'Antiquaille. 

" Recherches cliniques et experim. sur la syphilis,'' Paris, 1861 (also,, 
Archiv. gen. de med., Pans, 1859, 5th Ser., XIII., pp. 129-417, and 
Gaz. hebdom, 1861, p. 589. 

1) Ten cases, chancre of nipple, nurses from nurslings (pp. 251-258 , 261). 

2) Case, chancre of nipple, from suction by a syphilitic woman, in- 
fecting 

3) Case, chancre of lip, nursling from above nurse-mother (p. 270). 

4) Case, chancre upper lip, from a bite (p. 273). 

5) Two cases, chancre of lip, glass-blowers; one of them had two 
chancres on upper lip and one on the lower (p. 276). 

6) Four cases, chancre of lip, from kissing (pp. 279, 280, 284, 285). 

7) Case, chancre lip, from using a spoon of a female cook (p. 282). 

8) Four cases, chancre of tonsil, in one family (grand-mother, two 
sisters, one brother) (p. 2S6). 

9) Two cases, chancre lip, in same family (child 15 months, and brother 
18 years ; child infected by kissing (286). 

"Traite des maladies veneriennes," Paris, 1866. 

ga) A very full description of Radesyge (p. 471). 

10) Cases, chancres of lip and tongue, from bites (p. 606). 
10a) Case of Waller (q. v. G ) (p. 613). 

n) Case, chancre both tonsils, nurse from nursling, using common spoon 
(p. 617). 

12) Mention of fifteen cases, infection of glass-blowers, from 1 858-1864; 
also of a large number seen after that date (p. 619). 

13) Two cases, chancre of eyelid (p. 693). 

14) Four cases, chancre of nose (p. 693). 



ANALYTICAL BIBLIOGRAPHY 359 



15) Two cases, chancre of chin, medical men, from scratching with in- 
fected fingers (p. 693). 

16) Case, chancre right cheek, house-keeper (p. 693). 

17) " Sibbens d'Ecosse." Diet, encycl. d. Sc. med., Paris, 1881, 3, s., IX., 
522-526.* 

Romanoff. Viatka. 

Sbornik. Meditz. Departamenta, 1876, Vol. I., Part II. 

1) Case, infant of 2 months, infected by a nurse of 12 years, by kissing. 

2) Same* infant infects its two sisters, 3 and T4 years old, a brother of 
8, and their mother. 

Rona, S. Buda-Pesth. 

Orvosi Hetilap. , No. iS, 18S9. (Monatsh. f. prakt. Derm., 18S9, p. 192). 

1) Case, chancre of right tonsil, five-year-old child. 
"Extra-genital Syphihsinfection mit Riicksicht auf die heimischen (un- 

garischen) Verhaltnisse." Gyogaszat, 1890, No. 50, a. c. t. (Monatsh. 
f. prakt. Derm., Vol. XII., 1891, p. 459). 

2) Statistics: forty-six cases extra-genital chancre; lip, 26; tonsil, 8; 
finger, 3 ; forehead, 1 ; eyelid, 1 ; conjunctiva, 1 ; face, 1 ; abdomen, 
2; right groin, 1; anus, 1; multiple chancre, 1. 

3) Case, chancre of forehead, in site of moist eczema ; patient in hospital 
and had assisted nurse dress a syphilitic. 

4) Case, chancre right lower eyelid, probably from a towel. 

5) Case, chancre left ocular conjunctiva, boy aged 4 years. 

6) Case, multiple chancres (four) from cupping-glasses in public bath- 
house. 

Soc. royale des med. du Budapest, Seance, Oct. 31, 1S91. AVeiner med. 
Presse, 1891-, pp. 1716, 1753. (Annales de Derm, et de Syph., Vol. 
III., Mar. 1892, p. 315). 

7) Case, chancre beneath crest of ilium, in a man of 35 years. 
Rosen von Rosenstein, N. Stockholm. 

" Underratelse om bjarnssjukdom," Stockholm, 1764. (German Edit., 
"Anweis. zur Kenntn. u. Kurd. Kinderk.,'' Gottingen, 6th Edit., 1798; 
with notes by Loder and Buchholz). 

1) Family epidemic in Stockholm, introduced by a nurse, eight persons 
infected (p. 728). 

2) Case, 2-year-old child, infected by servant's chewing her food (p. 737). 

3) Cases, two children, sisters, infected by nurse (p. 738). 

(Also under proper heads, cases of the editors, Loder and Buchholz, and 
two cases cited by Bierchen). 
Rosenthal, O. 

Verhand. der Berliner dermatol. Verein, Sitz., Jan. s, 1S91. (Archiv f. 
Derm. u. Syph., Vol. XXIV., 1892, p. 513). 

1) Case, chancre of hand in a physician; one of three which he has 
observed (cases of Lewin). 

Berliner med. Gesell., Sitz, Feb. 3, 1S92 (Monatsh. f. prakt. Derm., Vol. 
XIV., 1S92, p. 332). 

2) Case of vaccino-syphilis in a girl of 12 years. 

Roster, G. Florence. Hosp. S. Maria Nuova (Clinic of Prof. Pellizzari). 
Giorn. ital. d. mal. ven., etc., 186S, II., pp. 65, 136. 

1) Statistics: of 156 chancres during 1S67, 13 extra-genital ; lip, 3; eyelid 
j ; tonsil, 1 ; fauces, 1 ; female breast, 6. 

2) Twenty-six cases, nurse from nursling (pp. 160, 163). 

3) Two cases, nursling from nurse (p. 150). 

Roussel, A. Paris. 

" De la syphilis tertiaire dans la seconde enfancc et chez les adultes," 
Paris, 1 881. 
1) Statistics: infantile acquired syphilis, Lyons civil hospitals; 1S76, 
7 cases; 1S77, 10; 1878, 7; total, 24. 



3 6 ° SYPHILIS INSONTIUM 



2) Family epidemic, nurse infected by nursling, infects another nursling, 
the infant infects mother, and she her husband (p. 59). 

2d) Case, chancre of right tonsil, in child of 7 years, from using a spoon 

after mother (p. 70). 
2b) Case of Trousseau (p. 71). 

3) Case, chancre lip, child 2 years of age, source unknown, infects 

4) Two other children (chancre of throat) and grand-mother, who 
infects her husband (service of Dron) (p. 78). 

5) Case, infection, boy 9 years, from mouth-piece of cornet, used by 
some unknown person (service of Aubert) (p. 89). 

6) Case, infection, child 2^ years, source unknown (service of Dron) 
(p. 102). 

7) Case, chancre penis, child 15 months, source unknown (service of 
Dron) (p. 102). 

8) Case, chancre, inner surface of cheek, child 9 years, source unknown 
(service of Aubert) (p. 103). 

9) Case, girl 18, infected by mother in infancy, she from strange child 
(service of Aubert) (p. 196). 

10) Case, infection, child 12 years, from mother in infancy (service of 
Aubert) (p. 19S). 
(Other cases claimed as syphilis acquise, are not here quoted, as data in 
regard to infection are wanting). 
Roux. • 

Gaz. med. de Paris, 1852, p. 64 (also Mem. de l'Acad. med., 1853, p. 331). 
Case, chancre of tonsil, woman aged 50, from kissing her son. 

Ruggiere. 

Epidemic of syphilis at Capistrello. (See Demarchi and Tanturri). 

Rumpf, Th. Bonn. 

" Die syphilitischen Erkrankungen des Nervensystem," Wiesbaden, 1887. 

1) Case, chancre of lip, man 44; syphilis of brain (p. 264). 

2) Case, chancre of hand, medical man 26 years; tabes dorsalis 
(Pierson) (p. 387). 

Vogel, Archiv f. klin. Med., Bd., XX., p. 32. 

3) Case, infection at an autopsy (p. 183). 

Charcot and Gombaut, Archiv. de physiol, norm, et path., 1873, p. 143. 

4) Case, chancre of lip in female of 19 years (p. 316).) 

Rupp, J. 

" Syphil. Ansteckung ohneBeischlaf," Zeitschr. d. Nord-deut. chir. Verein 
f. Med. etc., Magdeburg, 1848, II., 6. 

1) Case, infection, nursling from dry-nurse. 

2) Case, infection, nurse-mother from preceding. 

3) Case, chancre fauces, husband of preceding, by breast-drawing 
through pipe-bowl. 

Russell, Alexander. 

" Nat. hist, of Aleppo evil particularly of the plague, with 

methods used by the Europeans for their preservation," London, 
1856.* 

Russell, C. P. 

Journ. Cutan. and Ven. Dis.. 18S4, II., p. 240. 
Case, chancre of right index finger. 

Rust, J. N. Berlin. Charite Hospital, Surgeon-in-Chief, etc. 
Rust's Magazin, Berlin, 1823, XIII , p. 542. 

1) Family epidemic of syphilis, starting from 4-year-old infant. 
Jahresber. Charite Krankenh., 1834. (Cited in Bolschwing " Syph. und 

Aussatz," p. 34). 

2) Statistics: of 820 venereal cases, 6 infected, sine coitu. 
" Helkologie, etc.," Berlin, 1842, p. 246. 






ANALYTICAL BIBLIOGRAPHY 361 

2d) Buccal propagation by tobacco-pipes. (See HuFELAND'sMakrobiotik, 

444)- 
2b) Buccal propagation by kissing. (See Alberti). 

3) Epidemic of circumcision syphilis in Cracow, 1805; first recorded 
instance, p. 247. (See Epidemics). 

4) Similar epidemic in Rhine provinces, official investigation, p. 247 
(See Epidemics). 

Ruthenberg, A. Bonn. 

" De syphilis ab aliis atque apartibus genitalibus exeunte ; observationes 
quasdam," Inaug. Dissert., Bonn, 1830. 
Eleven observations: of Wolf; Nasse (two); Klein; Kilian (two); 
Velten ; Kopp; Haase; Anonymous (two). (All of which see) 
Ryan, C. S. Melbourne. 

Australian Med. Journ., July, 15th, 1886, p. 305. 

1) Case, chancre of nose. (See Bird and Snowball). 

2) Case, chancre of lip, in an old lady from preparing the feeding-bottle 
of her syphilitic grand-child. 

Ryan, James P. Melbourne. Surgeon Skin Dept., Melbourne Hosp. 

Trans. Intercolonial Med. Congress of Australia, Second Session in Mel- 
bourne, Victoria, 18S9, p. 994. 
Case, chancre of forehead, in 3-year-old girl, probably infected by 
kisses of mother who had mucous patches in the mouth. 
Sabinin, A. Kh. (See Ssabinin). Voronej, Russia. 

Trans, of the 4th meeting of Zemsky Med. men of Voronej Gov. 1882, 
p. 40, et seq. 
Statistics: among 3098 consecutive cases of syphilis ; 121 children 
infected per os by their mothers; 54 children infected per os by other 
persons; 15 nurses infected by nurslings; 243 infected by family life; 
4 infected by contact with neighbors. 

Sabolotsky, A. 

Medicinskoe Obozrenaie, 1S84, p. 466. (Archiv f. Derm. u. Syph., 1S89, 
P- 251). 
Case, two chancres on right eyelid. 

Sadoul, L. Strasbourg. 

" De la transmiss. de la syph. du nourrisson a la nourrice," These de 
Strasbourg, 1848. 
Case, nursling infects nurse. 

St. Martin. Pans. Hop. d. Quinze-vingt. 

Bull, de la ciinique nationale Ophthal. d. Quinze-vingts, 1S84, II., p. 33. 
Two cases, chancre of left upper eyelid. 

Salleneuve. Paris. 

'• Sur la valeur semieotique des affect, ganglionnaires," These de Paris, 
1S52. 
Case, chancre of tongue, from prostitute. 

Salomon (father). Hamburg. Jewish Rabbi. 

Proc. deutsch. Rabbin. Versaml., Breslau, 1S46. (Cited by Jaffk). 
Epidemic of circumcision syphilis, from buccal lesions of psylle. 

Salsotto, G. Turin. 

"Sifilomi extra-genitali ed epidemic di sifilide," Torino, 1892. 

1) Statistics: private and public practice from Jan. 1st, 1SS4 to July 31, 
1892, 201 cases extra-genital infection, as follows; breast, 108; lip, 
61; arm, 12; chin, 3; finger, 3; anus, 2; groin, 2; upper eyelid, 2; 
cheek, 2; tongue, 2; thigh, forehead, back and gum, each r. 

The 108 cases with chancre of the breast communicated the disease to 
109 children and 66 adults, included in these were: 

2) 12 cases, vaccinal syphilis, one infected by saliva of operator (p. 4). 



362 SYPHILIS INSONTIUM 

* 

3) Lactation, 105 nurses infected by nurslings; all of these but 31 pro- 
pagated the disease further to 226 persons (p. 10). 

4) Among accidental cases; a) 2 of eyelids from kissing, p. 14-15, 
b) cheek, from bite, p. 15); c) cheek in girl from contact with pillow; 

p. 15 ; d) upper gum in a barber, p. 16, etc. 
San Juan, M. Madrid. 

Revista esp. d. oftalm., etc., Madrid, 1883, VII., p. 145, andBolet. demed. 
naval., San Fernando, 1883, VI., p. 198. 
Case of lactation syphilis. 
Sarda. Montpellier. Health-Officer. 

(Cited by Legrand, "De Tor et de mercure . . . . " 18S4, p. 439). 
Case, chancre of lip. 
Sardon, G. Paris. Hop. St. Louis. (Interne, service of Reynier). 

" Gommes du couturier," Annales de Derm, et de Syph., 1887, 2d Ser., 
VIII. , p. 406. 
Case, Fournier, probable chancre of right tonsil. (See Reynier). 
Sartorius, P. Strasbourg. Hospital for Venereal Diseases, Surgeon. 

" Frantzosenarzt " 1645. (Girtanner, p. 215). 

Cases of lactation syphilis. 
Sattler, R. Cincinnati. 

(Personal communication to De Beck, q. v.). 
Case, chancre of conjunctiva from kissing. 
Saulsay, Nicolais du. Fourgeies. 

Journ. d. med. chir. pharm. etc., Mar. 1759, p. 232 (Girtanner, No. 1184). 
Case, chancre right middle finger in obstetrician ; professional exposure 

Sauvages, F. B. de. Montpellier. Univ. Prof, of Medicine. 

"Nosologia methodica," etc., Venet., 1764, p. 781 (Rosen von Rosenstein, 
" Kinderk.," p. 727). 
Case, infection of medical man from resting head on pillow of patient; 
probably infected through saliva. 

Savy, ^Claude. Lyons. 

"Eruptions de la conjunctive,'' etc., These de Paris, 1876, p. 63. 
Case, chancre of eyelid in medical man, infected by patient coughing in 
face. (See Fournier). 

Sbordone, G. Naples. 

II Movimento med.-chir., 1882, Nos. 3 and 4, pp. 155-160. (Giorn. ital. d. 
mal. ven., etc., 1882, p. 361). 
Case, chancre of eyelid in a physician. (See Del-Monte 2 ). 

Scarenzio, A. Pavia. Univ. Prof, of Skin Diseases and Syphilis. 
Giorn. ital. d. mal. ven.,. etc., 1866, II., p. 12. 

1) Case, nurse infected by nursling. 

2) Case, infection of an 8-year-old, per os, by mother. 

3) Case, infection of a nursling, per os, source unknown. 

4) Case, infection of a 15-year-old, per os, from famiky. 
Giorn. ital. d. mal. ven., etc., 1880, p. 16. 

5) Case, infection of mother by own nursling (exception to Colles' Law). 
(Reported by Jullien. Also Annales de Derm, et de Syph., 2d. Ser., V., 

1884, p. 77). 

6) Inoculation of Scarenzio, himself, source not stated. 
(See Soffiantini). 

Schirajew, P. Moskow. Mjasnitzki Hosp. (Service of Posfelow). 

St. Petersburg med. Woch., iSSo, No. 39, p. 323. (Archiv f. Derm. u. 
Syph., 1881, p. 127). 

1) Case, chancre left tonsil, girl aged 28, from felknv-cook. 

2) Case, nursling infected by wet-nurse. 

3) Case, chancre, left tonsil, mother from above nursling. 



ANALYTICAL BIBLIOGRAPHY 3 6 3 

Schlegel, J. H. G. Jena. 

" Material f. d. Staatsarzneiwissensch. u. prakt. Heilkunde,'' Jena, 1S04, IV. 
Syphilis insontmm by buccal secretions, " oscula pocula" (Plouquet). 
Schmalz, C. L. Leipzig. 

" Seltene chirurg. u. med. Vorfalle," Leipzig, 1784, S°, pp. 162-164. 

1) Case, nursling infected by nurse. 

2) Case, mother of above from own nursling. 
Schneider. 

" De catarrhis," p. 415. (Plouquet, " per salivam, osculum "). 
Schnitzler, J. Vienna. Univ. Prof. Dis. of Respiratory Organs. 

" Lungensyphilis und .... Lungenschwindsucht," Wien, 1SS0 (Wiener 
med. Presse, 1S79, XX.). 
Two cases, chancre of finger, in medical men. (Obs. V. and p. 20). 
Schnur. 

" Ueber die Lustseuche in Litthauen u. ihre Behandlung,'' Med. Zeitsch. 
d. Verein f. Heilk. in Preussland, 1S37, Nos. 50, 51. 

1) Syphiloid of Lithuania. 

"Med. Zeitsch. d. Verein f. Heilk. in Preussland, 1S39, Nos. 17, 18; 1841, 
Nos. 2, 3. 

2) Petty epidemics of family syphilis. 

Schubert, P. Xiirnberg. Eye and Ear Clinic of H. Cohn, Breslau. 
''Syphil. Augenkrankheiten," Berlin, 1881. 

1) Statistics, of 35 histories; 2 extra-genital (?). 

2) Case, midwife professionally inoculated (p. 82, obs. 20). 

3) Case, possible infection per os, fauces (p. 112, obs. 35). 
Schiiller, M. Vienna. 

Wiener med. Wochenschr., 1S61, No. S, (Jahrb. f. Kinderheilkunde, 1S61, 
No. 4). 

1) Case, chancre of finger, in 6-year-old attendant, from nursling. 

2) Case, chancre back of hand, in wet-nurse, from nursling. 
Schurig, M. Dresden. 

"Sialogia histor. med.," Dresdeae, 1723. (Monatsh. f. prakt. Derm., 1SS8, 
p. 190). 
Case, child infected on an abraded surface, by kiss of nurse. 
Scott, J. M. J. Belfast. 

Med. Press and Circular, Jan. 29, 1873, L, p. 84. 

Case of vaccino-syphilis (in practice of Purdon, q. v.). 
Sebastian. Beziers. Maternite, Physician. 
Gaz. des Hop., Oct. 22, 1863. 

Case vaccino-syphilis (reported by Blot, q. v.). 
Secheyron, L. Paris. 

Annales de Derm, et de Syph., 1SS6, VII., p. 75. 

1) Case, weanling, from foster-mother. 

2) Infection of child under 5 years from foster-mother, or possibly 
Eustachian infection. 

Se>. 

Gaz, hcbdom. de med. et de chir., Mar. 9, 1S55. 

Epidemic of vaccino-syphilis. (See Lancereaux % and HObner). I 

Seeley, W. W. Cincinnati. Med. Coll. of Ohio, Proi. Ophthalmology. 

Case, chancre of eyelid. (See De Beck). 
Segel. 

Pitha-Bilroth, ITandb. d. Chirurgic. (Cited by Jaff£, q. v.). 
Case of circumcision syphilis. 

Selenew, J. Th. 

Verhand. des Kiewschen Militarhosp., Mar. 1891, Vratsch., 1891, No. 15 
(Monatsh. f. prakt. Demi., Vol. XIII.. 1891, p. 32). 



364 SYPHILIS INSONTIUM 



1) Case, chancre right tonsil, in 21-year-old married man, infection 
probably from neighboring syphilitic family. 

2) Case, probable chancre of tonsil, in a 22-year-old man. . 

Selli. 

One of the investigators of the endo-epidemic at Capistrello. (See 

Demarchi, Tanturri, Durante, Ruggiere). 
Serduckov, A. S. St. Petersburg. 

Voyenno-Meditsinsky Journal, June, 1S90, p. 119 (St. Louis Med. and 

Surg. Journal, Sept., 1890, p. 235). 

1) Case, chancre upper eyelid in a wet-nurse. 

Vratsch., No. 14, 1892 (St. Louis Med. and Surg. Journ,, June, 1892). 

2) Case, chancre right tonsil, in man of 23 years, from smoking cigarettes 
in common. 

3) Case, chancre right side soft palate, in man of 25 years from cigarette 
smoking. 

Vratsch., 1892, No. 18, p. 462. 

4) Case, chancre middle of upper lip, in a boy of 15 years, source 
unknown. 

Settegast. Coblenz. 

Rust's Magazin, Berlin, 1823, XV., p. 146 (Hacker, "Lit. der Syph." 
Leipzig, 1830, p. 144). 
Epidemic of lactation syphilis, in two communes near Coblenz. (See 
Epidemics). 
Seutin. (See Joly). 
Seweke, W. Prof. Tarnowsky's Clinic (assistant). 

Russkaja Medicina 1886, No. 42. (Archiv f . Derm. u. Syph., 1889, p. 251). 
Two cases, chancre of tonsil from Eustachian catheterization. 
Shand, J. C. Phys. for Dis. of Women and Children, Glasgow Public Dis- 
pensary. 
Med. Press and Circular, London, 1S82, N. S., 33, p. 135. 

1) Case, nursling infected by nurse. 

2) Case, chancre of mouth in the mother. 
Sheild, A. M. London. 

British Med. Journ., 1887, I., p. 274. (MonaKh. f. prakt. Derm., Vol. VIII., 
1889, p. 208). 

1) Case, chancre at angle of mouth, in 32-year-old woman. 
British Med. Journ., Jan. 30, 1892, p. 228. 

2) Case, chancre left cheek in widow of 34 years, source unknown. 
Sherwell, S. Brooklyn, N. Y. 

Proceed. N. Y. Derm at. Soc, Journ. Cutan. andVen. Dis., 1886, p. 84. 

1) Case, chancre lower lip, in girl of 20 years. 

Proceed. N. Y. Dermat. Soc, Journ. Cutan. and Genito-Urin. Dis., 1887, 
p. 311. 

2) Case, chancre both nipples, from nursing 6-months-old hereditarily 
syphilitic infant. 

Shoemaker, J. V. Philadelphia. 
'• Diseases of the Skin," 1888. 
Case, chancre of lip, from kissing. (Plate, p. 153). 
Sick. Muskan. 

" Seltene Arten von syphilitischer Ansteckung." Med. Zeit'g, herausg. v. 
Vereine f. Heilkunde in Preussen, Berlin, 1837, No. 13.* 
Unusual methods of syphilitic infection. 

Sigmund, Carl von. Vienna. 

" Ueber die syph. Ansteck. durch Cigarren-Rauchen," Wiener med. Woch- 
enschr., 1853, III., No. 10, p. 145. 

1) Case, chancre, lower lip, \\\ a man. 

2) Case, chancre, both lips, in a woman. 



ANALYTICAL BIBLIOGRAPHY 365 

Wiener med. Wochenschr., 1854, Xo. 9, p. 132. 

3) Case, chancre of nipple, nurse from nursling. 
Wiener med. Wochenschr., 1S54, Xo. 16, p. 241. 

4) Eleven cases, chancre of ringer, from professional exposure. 

5) Case, chancre of nipple, nurse from nursling. 

6) Case, chancre of finger, from contact. 

7) Case, chancre of the vulva, from washing with a sponge. 

8) Case, chancre on the neck, and shoulder, from bandaging. 

8a) Zeitschr. der Wiener Aerzte, 1855, p. S7.* (Cited by Rollet, 

"Traite," etc., 1S66, p. 465). 

A personal study of Scherlievo, Facaldina, etc. 
8b) Zeitschr. der Wiener Aerzte, 1S55, p. 33.* (Cited by L.a^cereaux, 

"Traite," etc., p. 42). 

Personal account of " Mai di Breno," and " Fienga." 
Wiener med. Wochenschr., 1863, Xos. iS, 19, 21, p. 290, 291. 

9) Case, chancre of finger, midwife, infecting 

10) Child, chancre at right angle of mouth. 

11) Four cases, chancre of upper lip, in glass-blowers. 
11a) Three cases, chancre of lip, from blow-pipe. 

12) Case, chancre at angle of lip, nursling from nurse. 
Wiener med. Wochenschr., 1S65, p. 1430. 

13) Mention of 29 cases* chancre of finger. 

14) Mention of 5 cases, chancre of nipple. 

15) Statistics: 75 cases extra-genital chancre ; lip, 40; tonsil, 5; tongue, 2; 
nose, 1 ; finger, 27 (p. 1445). 

Wiener med. Wochenschr., 186S, p. 137. 

16) Four cases, chancre of lip. 

17) Statistics: 73 cases, chancre of lip, from 1S61-67. 
Wiener med. Wochenschr., 1S7S, p. 562. 

18) Statistics of chancre acquired late in life: finger, 9; mouth, 7; 
nipple, 1; by sucking, 8; total, 25. 

Signorini, Mario. Florence. Univ. Clinic for Syphilis. 

Lo Sperimentale, iSSS, p. 249. (Giorn. ital. d. mal. ven., etc., 1S88, p.220). 
Seven cases of vaccinal syphilis: 15 children vaccinated from same 
infant ; first 6, from clear vesicles, not infected. 
Simon, F. A. Hamburg. 

" Antwortschreiben auf Ricord's Briefe." Hamburg, 1S51, I., p. 9. 

1) Case, obstetrician, professionally infected; life-long invalid therefrom. 
"Kritische Geschichte der Syphilis." Hamburg, 1858, II., 1, p. 133, note. 

2) Family epidemic of syphilis in Hamburg ; physician sued for damages. 
" Kritische' Geschichte d'er Syphilis," Hamburg, 1S60, II., Theil, II., 

abstract, p. 103. 

3) Five cases of Lebe.nwald, from bleeding with a lancet. (Lebex- 
wald, q. v.). 

Simoneau. Florensac. 

(Legkand, " De Tor et du mercure," 1846, 2d Edit. Obs., 377). 
Case, chancre of tongue from kissing. 

Simonet. Paris. Surgeon to Hop. du Midi. 

1) Case, chancre of cheek, from bite. (See Hortei.oup and Leprovost). 

2) Case, chancre of nucha, direct contact. (See Ciiiher and Rizat). 

3) Case, chancre of nipple, wet-nurse. (See Audoynaud). 

Sims, J. Marion. New York. Surgeon to the Woman's Hospital. 
Transact. Amer. Med. Ass'n, Vol. XXIV., 1-76, p. 104. 

1) Two cases, chancre of finger, in medical men, professionally infected. 

2) Family epidemic, husband infects wife and four children; towels, 
basins, etc. 

3) Case, mother infected in the eye, from towels of son. 
(See also Price, J. H.). 



366 SYPHILIS INSONTIUM 



Siredey. Paris. Hop. Lariboisiere. 

(See Audoynaud and Morel-Lav allee). 
Sirski, K. L. Moscow. Clinic of Polotebnoff. 
British Journ. of Derm., Oct., 1889, p. 424. 
Case, chancre of finger, in a man. 
Sistach. 

Gaz. med. de Paris, 1863, p. 1. 

Case, chancre left arm, female 18 years from vaccination. (Service of 
Trousseau). 

Skae, D. 

" Condyloma, a primary form of venereal disease identical with Sib-bens." 
North. Journ. Med., Edinb., 1844, I., pp. 89-104.* 
Skinner, T. Liverpool, England. 

British Med. Journ., 1864, I., p. 595; 1865. I., p. in. 
Case, chancre of breast, from a syphilitic nursling. 
Smith, J. L. New York. 

New York Medical Journal, 1857, p. 341. 
Case, nursling infects nurse. 
Smith, T. London. 

Trans. Clin. Soc, London, 1871, p. 53. 
Case of vaccino-syphilis. 
Smith, W. P. San Francisco. 

Western Lancet, San Francisco, 1872, I., pp. 33-38. 
Case, chancre of eyelid. 
Snell, S. Sheffield. 

Lancet, London, 1882, I., p. 522. 

1) Epidemic from lactation. 

British Med. Journ., 1882, II., p. 1252 (also Trans. Ophthal. Soc. of Great 
Britain and Ireland, 1883, p. 4). 

2) Case, chancre inner canthus of eye in young woman, from manifold 
exposure to a five-months-old infant. 

Snitzer, S. Bamberg. Archiatrus (Physician -in-Chief). 

Describes the epidemic from cupping at Bamberg, 1603, in a letter to 
Libavius, published both by Hornung and Horst (q. v.). 

Snowball, W. Melbourne, Australia. 

Austral. Med. Journ., July 15, 1886, p. 305. 

Case, chancre ala of nose in a dry-nurse, from a tooth wound by a nursling. 
(See Ryan, C. S. 1 and Bird). 

Soffiantini, G. Pavia. Clinic of Scarenzio. 

Giorn. ital. d. mal. ven., etc., 1885, pp. 12, 142. 
Thirteen cases, nurses infected by nurslings. 

Sokoloff. 

Archiv f . gerichtliche Medizin. St. Petersburg, 1867, No. 2. 
An article on the Berreshof Disease, a " Syphiloid" of Siberia. 

Solari, B. T. 

Circulo Medico Argentino (St. Louis Med. and Surg. Journ., 1890, LIX., 
No. 4, p. 225). 
Case, chancre of right Eustachian tube in a prostitute, aged 32 years, 
acquired probably through unnatural practices. 

Soler-y-Buscala, Juan. Spam. 

Revista de las Ciencias Medicas. (Provincial Med. Journ., i8go, IX., 
p. 43). Also " Varios casos de sifilis," Barcelone, 1S90). 

1) Case, chancre of lip in a man, mode of infection not given. 

2) Case, chancre of lip, laborer, from wife, who had contracted the dis- 
ease in wet-nursing. 



ANALYTICAL BIBLIOGRAPHY 3 6 7 

3) Case, chancre of cheek, infection from a bite (Practice of Dr. Homs, 
of Mogas). 

4) Case, chancre of tongue in an infant, suckled by another woman after 
mother's milk failed. 

5) Case, chancre of nipple, in mother of above infant; he slept with her 
and used to suck her empty breasts at night. 

6) Case, chancre of arm in the grand-mother of this infant ; from carry- 
ing it. 

Solis-Cohen, J. Philadelphia. 

"Diseases of the Throat and Nose," Philadelphia, 1S79 (2d Edit.). 
Case of Eustachian-sound inoculation (p. 119). 
Solomon, J. Vose. Birmingham. Queen's College, Prof, of Ophthalmology. 

British Med. Journ., 1S63, p. 236. 

1) Case, chancre of eyelid, in 8-months-old child, from saliva "sputtered" 
into its face, by its aunt who had buccal lesions. 

2) Case, chancre of nipple in mother of above child, developed after 
buccal lesions were present in child's mouth. 

British Med. Journ., 1S69, II., p. 645. 

3) Two cases of probable vaccination syphilis. 
Solovioff. 

London Medical Recorder, July 1890, p. 266. 
Case, chancre of little finger. 
Sommerbrodt, J. 

Wiener med. Pr'esse, 1870, p. 413 (Archiv f . Derm. u. Syph., 1882, p. 500). 
Case, chancre of lip, in a girl. 
Sommering. 

" De morbis vasorum absorbentmm.'' (Clossius). 
Case, or cases of infection of anatomists from syphilitic cadavers. 
Sonsino, Prosper. 

Imparziale di Firenze, 1S70, Apr., and May. (Annales de Derm, et de 
Syph., Vol. II., 1870, p. 449). 
Discussion on circumcision syphilis. 
Sotchara. 

Trans, of the 1st St. Petersburg Gov. sanit. meeting; Feb. 6, 1875, 

PP. 3-9- 
Case, chancre ot nipple, nurse from nursling ; she in turn, infected her 
own infant and husband. (See Polotebnoff). 
Souchier. 

(Cited by Legraxd " De l'or et du mercure,'' 2d Edit. Paris, 1842, p. 174). 
Case, multiple chancres of breast, nurse from nursling. 
Spaack. Brussels. Prof. Thiry's Clinic. 
Presse med. Beiges, 1862, No. 48.* 
Article on cephalic chancre. 
Sparks, E. J. London. Charing Cross Hospital. 
Lancet, London, 1874, II., p. 869. 

Case of acquired syphilis in a child 12 years old, of healthy parentage. 

Speransky, N. S. Moscow. 

Russkaja Medicina, 1SS8, No. 39, p. 624 (Archiv f. Derm. u. Syph., 1889, 
P- 251). 
t) Case, chancre of nose, from a bite during a quarrel. 
Meditzina, 18S9, No. 52, p. 1. 

2) Case, chancre, lower lip, in girl of 15. 

3) Case, chancre, both fauces, in girl of 14. 

4) Case, chancre of fauces, in girl of 15. 

(All seamstresses in same house, from common use of utensils). 
Vratsch., 1891, No. 7, p. 207 (Annales de Derm, et de Syph., 1891, p. 419). 
5) Statistics: 80 to 90 per cent, syphilis in country districts, extra-genital; 



368 SYPHILIS INSONTIUM 

in Miasnitskaja hospital, Moscow, in 1888, males, 4.78, females, 8.86 
per cent.; in 1889, males, 6.87, females, 12.15 per cent; in 1890, 
males, 6.88, females, 18.15 per cent. ; total, 313 cases of extra-genital 
infection, among 3258 cases. 
Meditzinskoe Obozrenaie, 1892, No. i,p. 90. 

6) Five cases, chancre of nipple, nurses from nurslings, in Oct. and Nov., 
1 891. 

(All nurses from nurse bureaus, of which there are over 50 in Moscow ; 
syphilis is thus daily increasing and infection of nurses or nurslings 
is an "every day occurrence"). 
Sperck. 

(Cited by Petersen, Monatsh. f. prakt. Derm., 1888, p. 309). 

In Kalinkin hospital in St. Petersburg, 24.3 per cent, extra-genital 
infection in syphilitic women. 
Sperino, C. Turin. 

" La sifilizzazione studiata qual mezzo Curat " Torino, 1853. 

1) Case, nurse infected by nursling (p. 25). 

2) Three chancres produced by puncture with unclean lancet, used seven 
months previously for syphilization inoculations (p. 97). 

Spillman, P. Nancy. 

Rev. med. de l'Est., 1878, p. 292 (Annales de Derm, et de Syph., 1879, 

P- 79)- 

1) Case, chancre, right tonsil, woman aged 59, from foster-child, through 
nursing-bottle. 

2) Case, chancre lip, upholsterer's apprentice, from fellow-workman; 
saliva on tacks held- in mouth. 

Spoof, B. Abo, Finnland. Hospital of Abo. 
Upsalalak., For., 1873, VIII. , p. 352. 

Epidemic from cupping ; 1 7 received at hospital, claiming this source for 
their disease. (See Epidemics). 
Sprakel, H. 

" De morbo qui dicitur Radesyge," Hales Saxonum, 1864. 
Ssabinin. (See Sabinin). 

(Cited by Herzenstein, "Syph. in Russl." Bd., I., p. 492, and Beloussow, 
Arbeit des II., Congr. russ. Aerzte, 1887; Archiv f . Derm. u. Syph., 
1889, p. 252). 
Statistics: in Gov. Woronesch, of 865 syphilitics; 201 by coitus; 219 hered- 
itary ; and 445 from family life. 
Stahl, G. E. and Holl, J. S. Halle. 

" Dissertatio de requisitis bonae nutricis." Halae, 1698. 

Case, girl seven years old, syphilitic, probably from lactation. 
Stanch, F. A. St. Petersburg. 

Vratsch., No. 14, 1892 (St. Louis Med. and Surg. Journ., June, 1892). 
Case, chancre of lower lip, in man of 37 years, cause not stated. 
Stanley, E. London. St. Bartholomew's Hospital, Surgeon. 
British Med. Journ., June 20, 1857. (See also Mason). 

Case, chancre of lip, in a nurse attendant on syphilitics; probably 
through digital auto-infection or through a towel. 

Stark, J. Edinburgh. 

Edinburgh Med. and Surg. Journ., 1851, p. 366. 

Case, probable chancre of tonsil, elderly dry-nurse from nursling. 

Startin, J. (Senior). London. Hospital for Skin diseases, Blackfriars. 
Discussion, Royal Med.-Chir. Soc, 1871. 

1) Statement: had seen 30 cases of vaccinal syphilis in as many years. 
British Ass'nMed. Journ., 1870, 1S71 (Nayler, "Dis. of the Skin," London, 

1874, p. 355). 

2) Two cases of vaccinal syphilis (seen witn Mr. Nayler, q. v.). 



ANALYTICAL BIBLIOGRAPHY 3 6 9 



Steele, F. London. Resident Medical Officer, Bloomsbiiry Dispensary. 
Medical Press, 1S91, LI., p. 270. 

Case, chancre, upper lip, woman 31 years, in site of crack in lip, attri- 
buted to having held tacks in the mouth. 
Steffens. Christiania. 

Norsk. Mag. f. Laegevidensk., 1S41, p. 1. 
Epidemic of family syphilis. 
Steffens, M. M. H. Christiania. 

One of three appointed to investigate Radesyge in Norway; results 
reported April 30, 1774, as regards the disease in Christiansand. 
(Cited by Boeck, "Traite d. 1. Radesyge," etc., 1S60, p. 6). 
Stein. Gdov, Russia. 

Trans, of the 1st St. Petersburg Gov. sanit. meeting, Feb. 6, 1875, pp. 3-9. 
Eight cases, chancre of, or about nipple, nurses from nurslings; these 
infected upwards of 60 relatives and neighbors (see Polotebnoff). 
Steinbach. 

Internat. klin. Rundschau, 1SS7, p. 366. (Archiv f. Derm. u. Syph., Vol. 
XXL, 1SS9, p. 2S4). 
Case, chancre of temple in physician, following application of leeches ; 
source of infection unknown. 
Steinberger. 

Busch's neue Zeitsch. f. Geburtsh., 1S34, II., p. io3. (Cited by Dieterich, 
"Die Krank. Fam.," etc.). 
Five cases, nurslings infected by nurses. (Author supposes this to occur 
through the milk). 
Stellwag von Carion, Carl. Vienna. 

Die Ophthalm. vom naturwissensch. Standpunkt, 1S58, Bd. , II., p. 954. 
Case, chancre of eyelids, from contamination with fingers. 
Stepanoff, A. D. St. Petersburg. 

Vratsch., 1890, No. 40, p. 625; No. 44, p. 1012. (Monatsh. f. prakt. Derm., 
Vol. XL, 1890, p. 549). 

1) Case, chancre both breasts, in wet-nurse aged 32, in foundling 
hospital. 

Vratsch., 1S91, No. 1, p. 21. 

2) Case, chancre left nipple, nurse from nursling. 

Stevens, J. G. B. London. 

British Med. Journ., 1S90, II., p. 1477; Lancet, London, 1S90, II., p. 1334. 
Case, chancre ulnar side of last phalanx, middle finger, married man 
aged 50; mode of infection not discovered; disease communicated by 
him to a second person. 

Stirling, R. A. Melbourne, Australia, 

Austral. Med. Journ., Apr. 15, 18S5, p. 15S. 

1) Two cases, chancre of lip, in young ladies from kissing. 

2) Case, chancre of lip, in a man 

Trans Intercolonial Med. Congr. of Australia, Second session, Melbourne, 
Victoria, Jan. 18S9, p. 991. 

3) Case, chancre lower lip, in child 6 months old, possibly from recur- 
rence of old syphilis in mouth of the father. 

Austral. Med. Journ., 1890, XIL, No. 3, p. 127. 

4) Case, syphilis acquired through tattooing ; operator at the time was 
free from ulcerative lesions in the mouth, though with annular 
syphilide on the body. 

Stoll, M. Vienna. Univ. Prof, of Medicine. 

" Ratis medendi," etc. Vienna, 1777-90, III., p. 392. 
1) Two children aged 9 and 10 years, from father (possibly late hered- 
itary syphilis). 
" Praelectiones in diversos morb. chron.," 1787, pp. 101-2. 

25 



37° SYPHILIS INSONTIUM 

2) Nursling from another nursling, through the nurse. 

3) Family epidemic: nursling infected by nurse; mother and rest of 
family from nursling through kissing. 

Stourme, A. Lyons. 

" Essai sur la progn. du chan. cephal. indur.," These de Lyon, 1889. 
One hundred and three cases, cephalic chancre- from service of Aubert, 

17; AUDRY, 2; AUGAGNEUR, I J CENAS, 4; CORDIER, 12; DlDAY, 6; 

Farre, i; Gailleton, 44; Guillaud, 7; Poncet, 4; Rollet, 5 ; q. v. 
Stratton. 

Edinb. Med. and Surg. Journ., Vol. LXXI., p. 276 (cited by Lancereaux, 

"Treatise on Syphilis," 1868, Vol. I., p. 40). 
St. Paul's Bay Disease. 
Strauss, Arthur. 

Dr. Unna's Clinic in Hamburg. Monatsh. f. prakt. Derm., Vol. XV., 
No. 10, p. 509. 
Case, chancre lower lip, cause not stated. 
Streatfield, J. F. London. Surgeon to Ophth. Hospital, Moorfields. 
Brit. Med. Journ., 1882, II., p. 634. 

1) Case, chancre, inner canthus left eye. 
(Reported by De Beck, q. v.). 

2) Several cases, chancre of eyelid, but no particulars given. 

Strieker, W. 

Virchow's Archiv, Berlin, 1861, XXIL, p. 285. 

Review of vaccinal syphilis, giving large number of references, but no- 
original cases. 

Struve, L. A. 

" Ueber die aussatzartige Krankeit Holsteins, allgemein daselbst die 
Marschkrankheit genannt. Ein Beytrag zur Kenntniss der Pseudo- 
syphilitischen Uebel," Altona, 1820. 
An original and full account of Morbus Dithmarensis. 
Stukowenkow, M. J. Kiew, Russia. 

Protoc. d. Sitz. Kiew'schen Aerzte, 1885, p. 54; 1886, p. 45. (Archiv f* 
Derm. u. Syph., 1889, p. 252). 

1) Case, chancre of tonsil, probably through kissing child. 

2) Case, chancre, right cheek, married woman, aged 24. 

Sturge, A. London. 

Med. Times and Gaz., 1877, H., p. 116. 

1) Three cases, nurses infected by nurslings. 

2) Family epidemic: infant infected by nurse, communicated chancres 
of lips or tongue to mother, father, grand-mother, and others, by- 
means of its fingers put into their mouths. 

Sturgis, F. R. New York. University, Prof, of Venereal Diseases. 
New York Med. Record, 1868, p. 530. 

1) Case, chancre right cheek, man aged 38, from a bite (case of 
Bumstead's). 

Amer. Journ. Med. Sci., Vol. LXV., 1873, p. 102. 

2) Case, chancre, right lower eyelid, infant aged 22 months. 

3) Case, chancre of left cheek, sister of preceding, aged 6 (cases of 
Loring). 

American Specialist, 1881, II., p. 65. 

4) Case, chancre of lip, in young woman. 

5) Case, chancre of tonsil, source unknown. 

Suchanck. Prague. General Hospital, service of Waller. 
Prag. Viertelj., 1849, XXIII., pp. 48, 49. 

1) Among 472 cases of chancre in women ; right nates, 1 ; right groin, 2' r 
finger, 1. 

2) Among 234 cases of chancre in men; upper lip (auto-inoculation) 1. 



ANALYTICAL BIBLIOGRAPHY 37* 

Prag. Viertelj., 1853, XL., p. 93. 

3) Case, nurse infected by nursling. 
Prag. Viertelj., 1854, XLL, p. 55. 

4) Case, nursing mother, infected by foundling. 

5) Case, chancre right index finger, in a midwife, in 1845. 
Suche, S. 

L'Union med. , Paris, 1853, VII., p. 37. 

Case, chancre of left shoulder, m man 19 years old. 
Sutton. R. S. Pittsburg, U. S. A. 

Journ. Amer. Med. Ass'n, 1886, p. 642. 
Two cases, infection by kissing. 
Swediaur, F. 

" Traite complet . . . des mal. syphilitiques," Paris, 1S01. 

1) Two children, sisters, infected from sleeping with syphilitic servant 
(p. 89). 

2) Statement: has seen many examples of midwives and surgeons 
infected ; one midwife infected over one hundred women (p. 96). 

3) Statement: many examples, infection by lancets and surgical instru- 
ments. 

4) An account of the Disease of St. Paul's Bay (p. 371). 
Sydow. 

Gefneberg's Hala. Lakar. For., 1879, No. 6. 
Two cases, chancre of nipple, nursing-women, from a male breast 
drawer. 
Symonds, C. J. London. 

Brit. Med. Journal, 1890, II., p. 1477. 

In discussing a case cf chancre of finger, stated that he had seen many 
similar cases, five in medical men. 
Szadek, K. Kiew, Russia. 

" Primitive syphilitic sclerose of throat" (Russian), Kiew, 1884 (Medicinsk. 
Westnik., 1884. Nos. 2S-30, 36-40). 

1) Case, chancre left tonsil, soldier aged 21 (p. 16 of reprint). 

2) Case, chancre right tonsil, soldier aged 23 (p. 19). 

3) Case, chancre tonsil, child aged 3, from kissing nurse (p. 22). 
(Reference to 65 cases from literature). 

Provincial Medical Journal, Sept., 1S87, p. 422. 

4) Review of Russian cases of extra-genital chancre. 
St. Louis Med. and Surg. Journ., 1S91, LX., I., p. 9. 

5) Case, chancre right tonsil, in a married man 32 years old. 

6) Case, chancre right tonsil, in an unmarried man 40 years old. 

7) Case, chancre right tonsil, in a laboring man 40 years old. 

8) Case, chancre right tonsil, man 25 years old. 
(Xo cause given for the above four cases). 

Szokalski. Warsaw. 

Pamietnik Zowarzys. Lekar., 1880, p. 917. 

Case, chancre, conjunctiva of eyelid, from removal of eyelash by the 
tongue. 
Tait, L. Birmingham England. 

" Syphilitic Hemiplegia," etc., Med. Times and Gaz., Feb. 27, 1869. 
Case, chancre of finger, in medical man, professional exposure. 
Tanturri, V. Naples. 

II Morgagni, 1869, XL, p. 100. (Giorn. ital. d. mal. vcn etc., 1S69, 

I., P- 243)- 

1) Epidemics at Capistrello, and Castellafiume, previously reported by 
Dema&CHI, q. v. (See Epidemics). 

2) Epidemic at Roccavivi ; disease had existed 20 years under the nameol 
sc/u'avino (or vajnolo oviiw). 

(Cited by Profeta " Tratt. prat, delle mal. ven.," Palermo, 188S, p. 419). 



37 2 SYPHILIS INSONTIUM 



3) Case, chancre of nipple, mother infects own infant. 
(See also Camp ana and De Amicis). 

Tardieu, A. Paris. Prof. Legal Medicine, Faculty of Medicine. 
" Etude siir les mal. provoq. ou communiq.," etc. Paris, 1864. 

^(Cases reproduced in the following work) : 
"Etude medico-leg. sur les mal. prod, accident, ou involontaire.," Paris, 
1879. 

1) Case, chancre left breast, nurse from nursling (p. 160). 

2) Two nurses infected by same nursling (p. 166). (Seen with Adelon, 
and Devergie). 

3) Inoculation of patient with unclean vaginal speculum (p. 272). 

4) Inoculation of young man in operation for phymosis by serre-fmes 
(Service of Fournier). (p. 272.) 

5) Eight cases of Ricord's from Eustachian-sounds (p. 272). 

6) Case, nurse infected by nursling; 5,000 francs damages (p. 175). 

7) Case, chancre left breast, nurse from nursling ; culpable reticence of 
Dr. B. (p. 191). 

8) Case, nurse infected by nursling; defendants sustained (p. 195). 

9). Case, nurse infected by nursling, infects husband; 400 francs damages 
(p. 198). 

10) Case, nurse infected by nursling, infects husband; 3,000 francs from 
child's father (p. 199). 

11) Case, nurse infected by nursling (p. 203). (Reported by Dr. de 
Castelnau). 

12) Case, nurse infected by nursling (p. 214). 

13) Boy, aged 10 years, inoculated experimentally, right arm, from 
secretion of mucous patches ; visiting physician fined 50 francs, and 
interne 100 francs (p. 274). 

Tarnowsky, B. St. Petersburg. Univ. Clinic for Syphilis. 
Wojenko-Medicinski Journ., Feb., 1881, pp. 95-96. 

1) Two cases, chancre of chin, soldiers from razor cuts. 

2) Five cases, chancre of lip, in pupils of military school. 

Traite histor. et pratiq. de la syphilis, by Lancereaux ; translated by Tar- 
nowsky (p. 620). 

3) Case, chancre, upper third, inner side of right forearm, from a 
chancre on the left hip, which in turn was caused by a bite. 

Proc. of the Russian Dermat. Soc, 1886-87, p. 135. 

4) Two cases, chancre of eyelid, in women, from contact with amniotic 
fluid during labor. 

(All cited in Archiv f. Derm. u. Syph., 1889, p. 252; see also cases 
reported by Tschistiakow, and Zewecke). 

5) Personal communication, 1892: chancre of lip, 45 ; mouth (cavity), 24; 
finger, 15; tongue, 3; pharynx, 3; eyelid, 2; chin, 2; abdomen, 2; 
anus, 2; nose, 1; neck, 1. 

Tassani. Cremona, Italy. 

Gaz. med. di Milano, 1843, II., No. 4 (Cited by Bouvier, " Syph. Vacc," 
Acad, de med. de Paris, 1865, p. 162). 
Epidemic of vaccino-syphilis at Grumello: 56 vaccinated, 35 infected, 
and from these, 29 mothers and nurses, total, 64; 8 children and 2 
women died. Cerioli, q. v., described same epidemic, later stage. 
(See Epidemics). 

Tay, W. London. London Hospital, Surgeon. 

See Hutchinson's second series of cases of vaccino-syphilis 

Taylor, R. W. New York. 

New York Med. Journ., Vol. XVIII., 1873, p. 563. 

1) Four cases, infection after circumcision, operator healthy, source 
unknown. 



ANALYTICAL BIBLIOGRAPHY 373 

" Syphilitic lesions of the osseous system in infants and young children," 
New York, 1875, p. 27. 

2) Case, chancre lower lip, girl, from her sister's child, congenitally 
syphilitic. 

Archives of Dermatology, New York, Vol. II., 1S76. (Also Amer. Journ. 
of Obstetrics, N. Y., 1875, VIII. , p. 436). 

3) C?„se, chancre right nipple, nurse 38 years, from nursling (p. 32). 

4) Case, chancre left nipple, nurse 19 years, from nursling (p. 34). 

5) Case, chancre left nipple, nurse McNally, 19 years, from nursling 

(P- 33). 

6) Case, infection after vaccination from unclean scarifier (p. 205). 

7) Case, chancre of mouth, child from kissing, infecting its nurse- 
mother with a chancre of nipple (p. 230). 

Archives of Dermatology, New York, Vol. V., 1879, P- 374- 

8) Case, chancre of mouth, sailor, from drinking-cup. 

9) Case, infection, young man, from a towel. 

" The Pathology and Treatment of Venereal diseases.'' Bumstead and 
Taylor, Phila., 1883. 

10) Case, chancre of nipple, from suction by husband (p. 464). 

11) Mention of infection of dentists, known personally (p. 464). 

12) Case, chancre, lower lip, female cigar-maker, from drinking-cup 
(p. 467). 

13) Case, chancre of chin, from shaving (467). 

14) Case, chancre left nipple, male, from bite (p. 468). 

15) Mention of two cases, chancre of tonsils (516). 
New York Med.- Journ., May 24th, 1884. 

16) Three cases, chancre of tonsil. 

" Atlas of Venereal and Skin Diseases,'' Phila. 18SS, p. 10S. 

17) Two cases, chancre of chin, female and male. 

18) Two cases, chancre of male breast, infected by woman. 
Journ. Cutan. and Yen. Dis., 18S9, p. 66. 

19) Case, chancre of tonsil, in a man. 

Journ. Cutan. and Genito-Urin. Dis., New York, 1890, p. 201. 

20) Fifteen cases of non-sexual chancres: probable modes of contagion; 
chewing gum, necropsy, caustic holder, handkerchief, bathing suit, 
syringe, pair of drawers, adhesive plaster, water closet seat, con- 
ductor's whistle, tongue scraper, towel, pillow, and razor. 

Medical News, Philadelphia, 1891, p. 214. 

21) Case, chancre upper lip, man 23 years old, from a bite. 
New York Med. Record, 1S91, XXXIX., p. 69. 

22) Case, chancre right index finger, in man 22 years old, source not 
stated. 

23) Case, chancre left index finger, in medical student, source not stated. 

24) Case, chancre right index finger, in woman, from dressing chancre of 
penis in her lover. 

25) Family epidemic, starting from chancre on finger of midwife ; mother, 
father and four children infected. 

Trans. New York Dermatolog. Soc., 2iSth meeting (Journ. Cutan. and 
Genito-Urin. Dis., Vol. XI., Jan. 1893, p. 2S). 

26) Case, chancre forehead near hairy border, in young man, inoculated 
by scratching mosquito bites with infected finger. 

Tchagin, A. A. St. Petersburg. 

Protoc. Russ. Syph. Derm. Soc, iSSS, Vol. II., p. 133 (Brit. Journ. of 
Derm., 18S9, p. 347). 

1) Case, chancre left eye (canthus), woman, from washing brother's linen; 
he had chancre of lower lip. 

Vratsch., No. iS, 1890, p. 496. 

2) Case, chancre upper lip, just beneath left nostril, man aged 20 years. 
Russ. Syph. Derm. Soe., Dec. 22, 1890 (Vratsch., Xo. 1, 1891, p. 21).' 



374 SYPHILIS INSONTIUM 

3) Case, chancre left cheek, man aged 24, from bite. 
Leicester Provincial Med. Journ., Mar. 1891, p. 174. 

4) Five cases of extra-genital chancres. 

Tchistiakow, M. A. St. Petersburg. (Clinic of Tarnowsky). 

Protoc. Sect. f. Syph. I. Congr. russ. Aerzte in St. Petersburg, 1885, 
p. 41 (Archiv f. Derm. u. Syph., 1889, p. 254). 

1) Statistics : percentage of extra-genital chancre ; lower lip, 30 ; upper 
lip, 15; tongue, 3; throat, 3; buccal cavity, 24; lower eyelid, 2; chin, 
2 ; neck, 3 ; nose, 1 ; finger, 14 ; finger and lower lip, 1 ; abdomen, 2 ; 
anus, 2. 

2) Case, chancre of throat, nurse from nursling. 

Protoc. russ. Gesellsch. f. Derm. u. Syph., 1887, p. 9 (Archiv f. Derm. u. 
Syph., 1889, p. 254). 

3) Case, chancre right tonsil, man aged 28. 

Vratsch., 1889, No. 5, p. 133 (Virch.-Hirsch, Jaresber., 1889, p. 634). 

4) Case, chancre of forehead, child 8 months, from nurse. 
Bolnitchnaya Gazetta Botkina, 1890, Nos. 7, 8. (Leicester Prov. Med. 

Journ., 1890, p. 306). 

5) Case, chancre inside of cheek, woman from cigarette. 

6) Case, chancre inside of cheek, lady from spoon used by syphilitic 
cook. 

Vratsch., 1S90, No. iS, p. 426 (Monatsh. f. prakt. Derm., 1890, Vol. XI., 
p. 69). 

7) Four cases, nurses infected by nursling, the latter infected by pre- 
vious wet-nurse. 

Vratsch., 1890, No. 40 (Monatsh. f. prakt. Derm., 1890, Vol. XL, p. 549). 

8) Case, chancre both tonsils, child two years old. 

9) Case, chancre left tonsil, girl of 15 years (case of Lewy). 

10) Case, chancre lower lip, man 38 years old. 

11) Case, chancre upper lip, girl 23 years old. 

12) Case, chancre nipple, nurse from nursling, from foundling asylum. 
Vratsch., 1891, pp. 21, 159 (Annales de Derm, et de Syph., 1891, p. 238). 

13) Case, chancre lower lip, prostitute of 17 years. 
Vratsch., 1891, No. 11, p. 300. 

14) Case, chancre left side of head, in site of contusion; student, aged 
21, infection by barber (?). 

Vratsch., 1891, No. 18 (Monatsh. f. prakt. Derm., Vol. XIII., 1891, p. 4S). 

15) Case, chancre dorsum of tongue, in woman aged 21 years. 

16) Case, chancre at junction of hard and soft palate, managed 34; being 
subject to throat affections, he had used atomizers of syphilitic 
patients. 

Vratsch., 1892, No. 18, p. 462. 

17) Case, chancre lower lip, in married man of 38, source unknown. 

18) Case, chancre abdomen left of median line, four fingers' breadth 
above pubes, in married man of 34 years, source unknown. 

Vratsch., 1892, No. 14. (St. Louis Med. and Surg. Journ., June, 1892). 

19) Case, chancre upper lip in student of 20 years, origin not stated. 

Tchudnowsky. 

Proceed. Caucas. Med. Soc, 1886, p. 161 (Archiv f. Derm. u. Syph., 1889, 
p. 254). 
Case, chancre of chin in site of razor cut. 

Tedenat. Lyons. Faculty Prof, of Clinical Surgery. 

(Cited by Roussel, " De la syph. tert. d. 1. sec. enf." . . . 1881, p. 90). 
Case, chancre of upper lip, in 2-year-old boy, from father, by mouth- 
piece of cornet. 

Temple, W. F. Boston. 

Boston Med. and Surg. Journal, July 2, 1S91. 

Case, chancre upper lip, in a young girl from kissing. 



ANALYTICAL BIBLIOGRAPHY 375 

Tenneson. Paris. Hop. St. Louis. 

Annales de Derm, et de Syph., Vol. X., 1889, p. 791. 

Case, two chancres on cheek of young girl, from kissing. 
Tepliaschin, A. P. Wjatka Gouv., Russia. District-Physician. 
Vratsch., 18S7, No. 17 (Monatsh. f. prakt. Derm., 18S7, p. 770). 

Epidemic of syphilis, from applying tongue to the eye ; 34 persons 

directly infected, and 34 others from them ; total, 68. (See Epidemics). 

(La France med., Feb. 7, 1S88, mentions epidemic of same character at 

Glastikow, Roumania, ascribed to Tepliachnis ; evidently the same 

episode). 

Theobald, S. Baltimore, U. S. A. 

Amer. Journ. Med. Sci., 1S73, Vol. LXVI., p. 423. 

1) Case, chancre of lip, infant from servant. 

2) Case, mother of above infant, infected by nursing. 
Thiry, A. Brussels. Prof, and Surgeon to Hop. St. Pierre. 

Presse med. Beiges, Bruxelles, 1S62, No. 48. 

1) Cases of cephalic chancre, reported by Spaack. 

Presse med. Beiges, Aug. 4, 1878 (Archivf. Derm. u. Syph., 1879, ^p. 472. 
Virch.-Hirsch. Jaresber. , 1878, Bd. II., p. 535). 

2) Two cases, chancre of eyelids. 
Presse med. Beiges, 1SS1, XXXIII., p. 193. 

3) Case, nurse infected by nursling. 
Presse med. Beiges, 1885, p. 409; i836, p. 9. 

4) Case, chancre of the tongue. 

5) Case, chancre of left tonsil. 

6) " Contam. chanc. d'un enfant pendant l'accouch.," etc. Presse med. 
Beiges, 1S84, XXXVI., pp. 241-246.* 

Thomas. Pittsburgh. 

Soc. Proceed. Allegheny County med. Soc, Dec. 15, 1S91 (Journ. Amer. 
Med. Ass'n, Vol. XVIII. , 1892, pp. 165-166). 

1) Case, chancre of lip, in a man, from kissing, infecting 

2) Case, chancre of forehead, his 2-year-old son, by kissing. 
Thomaschewsky, S. P. Kiew. Russia. Military Hospital. 

Russkaja med. voskresensk., 1885, pp. 346, 367, and Wiener med. Presse, 
1S86, 27, p. 969; 30, 36. 

1) Case, chancre left tonsil, virgin of 15^ years, attendant on infected 
child. 

2) Case, chancre right tonsil, soldier of 26 years, source unknown. 

3) Case, chancre left tonsil, in an attendant, 25 years old, in syphilitic 
ward of hospital. 

London Med. Recorder, Oct. 1S90, p. 396. 

4) Case, chancre of finger. 

(Unpublished cases, personal communication, 1S92). 

5) Statistics: chancre of pharynx, 7; lip, 6; eyelid, 4; buccal cavity, 4; 
forehead, 1 ; temple, 1; cheek, 1; finger, 5; breast, 4; arm, 1. — 
Total, 34. 

Tiling, R. 

" Ueber Syphilis und Syphiloid," Mitau, 1S33.* 
Tillaux. Paris. Hop. Lariboisiere. 

(Cited by Rizat, "Man. pratique des mat vener.," Paris, 1SS1, p. 71). 
Case, chancre dorsal surface of tongue. 
Todd, R. H. Dublin. Surgeon to Dublin Hospitals. 
Dublin Hospital Reports, 1819, II., p. 182. 

Case, infection of woman aged 70, from spoon of syphilitic grand-child; 
probable throat chancre. 
Tommasi-Crudeli. Turin. 

Instituz. di Anat. Patol., 1SS2. (Cited by Merz q. v.). 

Case, mother infected by nursing own child (exception to Colles' Law). 



37 6 SYPHILIS INSONTIUM 

Torella, G. Rome. Physician to Pope Alexander VI. 

"Tractatus de pudenagra cum consiliis," 1497. (Cited by Audoyna^jd, 

"Syph. comm. par l'allaitement," Paris, 1869, p. 8). 
Statement: had often seen an infant infect many nurses. 
Touchaleaume, A. 

" Etude sur le chancre syphilitique de la conjunctive.'' These de Paris, 
1889. 
Case, chancre conjunctiva, right upper eyelid, youth of 19 years from a 
kiss. (Service of Prof. Dianoux). 
Toujan. Toulouse. 

Annales de Gynec. etd'obstet., July, 1892 (Brit. Med. Journ., Sept. 3d, 1892, 
p. 39; epitome of current literature). 

1) Case, chancre lower lip in married man, infecting 

2) Case, probable chancre of lip in the wife. 
Tourner, G. R. 

Lancet, London, 1887, Vol, I., p. 218. 
Case, chancre of lower lip. 
Townsend, W. E. Boston. 

Boston Med. and Surg. Journ., Vol. LIX., 1859, p. 456. 

Case, chancre of breast, acquired from a syphilitic nursling. 
Trelat. Paris. Hop. de la Charite, Surgeon. 

(Cited by Jullien " Traite des mal. vener.," Paris, 1886, p. 552). 
Case, double chancre of chin. 
Trevisanello, G. Florence. Clinic of Prof. P. Pellizzari. 
Giorn. ital. d. mal. ven., etc., 1875, p. 307. 

1) Five cases chancre of tonsil ; one in a girl of 1 5 years, from infant 
nephew, child of a syphilitic soldier. 

2) Three cases, chancre of lip. 

3) Case, chancre of finger. 

4) Case, chancre nipple, nurse from nursling, infecting another nursling. 

5) Case, infection, nursling from nurse. 

Triboulet. Paris. Hop. St. Eugenie, Surgeon. 

(Cited by Audoynaud " Syph. comm. par l'allaitement. " These de Paris > 
1869, p. 28). 
Case, chancre of breas., nurse from nursling. 

Trivet. Paris. (Service of Fournier). 

These de Paris, 1887. (British Journ. of Dermatology, 1889, p. 426). 
Case, chancre of forehead. 

Trotter, Spencer. 

Philadelphia Med. Times, 1885-86, XVI., p. 125. 
Case of inoculation by tattooing, saliva on needle. 

Trousseau, A. Paris. Hop. Necker and Hotel-Dieu, Physician. 
Gaz. des Hopit., 1854, p. 358; 1855, p. 497. 

1) Case, chancre buttocks in baby, from contact with mother in bed. 
L' Union med , 1857, p. 207. 

2) Two nurses infected by same nursling. 

Gaz. des Hopit., 1862, p. 25 (also " Syph. vacc," Acad, demed., Paris, 1865, 
p. 69). 

3) Case, infection from vaccination, woman aged 18 years. (See 
Sistach). 

(Roussel " De la syph. tertiaire," Paris, 1881, pp. 142-143). 

4) Case, infection of girl of 7 years by a nurse. 

Tuholske. 

(Cited in the Archives of Gynecology, 1891, No 6, p. 347). 

Case, chancre of nipple, young married woman, from her infant with 
chancre of lip, acquired by kiss of a young man with syphilis. 



ANALYTICAL BIBLIOGRAPHY 377 

Tuilier. Limoges. Limoges Hospital. Physician-in-Chief. 

Some of the cases of lactation syphilis reported by Bardinet (q. v.), were 
in the hospital under the charge of Tuilier. 

Tur, M. 

Russkaja Medycyna, 1885, No. 39 (Monatsh. f. prakt. Derm., 1887, p. 41). 
Case, chancre right tonsil, followed by scorbutus-like syphilis. 
Turati, A. F. Milan. Institute d. St. Corona. Division for Syphilis. 

Annali universali di med. , 1S75 (Profeta "Trattato pratico'd. mal. ven.," 
etc., 1888, p. 414). 
Cited as reporting cases of lactation syphilis. 
Turner, G. R. London. Guy's Hospital. 
British Medical Journal, 1887, I., p. 212. 
Case, chancre of lip. 
Tzitrin. 

Voyenno-Sanitarnoie Dielo, St. Petersburg, 1887. 

Observed several cases of soldiers, contracting syphilis from the com- 
mon use of razors, combs, and cigarette stumps. 
Ussas, M. S. St. Petersburg. 

Proceed. Russ. Syph. Derm. Soc, 1888, Vol. II., p. 29 (British Journ. of 
Derm., Vol. I., No. 4, p. 133). 

1) Case, chancre left palm, on site of burn; from attending a syphilitic 
child, who had been infected by a wet-nurse. 

Vratsch., No. 18, 1890 (Monatsh. f. prakt. Derm., Vol. II, 1S90, p. 69). 

2) Case, infection of girl of 16, probably in mouth. 

3) Case, infection of an engineer, in same manner. 

4) Case, nurse infected by nursling. 
London Med. Recorder, Aug. 1890, p. 304. 

5) Case, chancre upper eyelid. 

Vratsch. No. 10, 1892 (St. Louis Med. and Surg. Journ., June, 1892). 

6) Case, chancre right tonsil, in married woman of 41 years; origin not 
stated, but husband syphilitic. 

Vadja, L. Vienna. Assistant, Clinic of Sigmund. 
Archiv f. Derm. u. Syph., 1875, p. 180. 

1) Case, chancre lower lip, man aged 20. 

Bericht der Klinik f. Syph., von Sigmund (Archiv f. Derm. u. Syph., 
1876, p. 124). 

2) Case Eustachian infection, girl aged 27. 
Valcourt. Paris. 

Gaz. des Hop., Paris, 1865, p. 445. 
Case, chancre of tonsil, from a lozenge. (Case of Prof. Hardy, reported 
by several observers). 
Valentine, E. 

Revista espec. de oftalmolog., derm., etc., Madrid, 18S6, 9, pp. 353-363. 
(Bibliog. Syph., Szadek, 1888, p. 20). 
Case, chancre of eyelid. 
Valenzasca. 

Annali universali di medicina, No. 93, fasc, I., Venet., 1840.* (Cited 
by LANCEREAUX, "Treatise on Syphilis," 1S68, p. 41). 
A description Facaldina. 
Valery, Chas. 

" De la transm. des accid. second, du nourrisson a la nourriee, et de celle-ei 
a son nourrice." These de Pari 1 ... 
Vallauri, G. Piedmont. 

Rep. med. chir. del Piemonte, 1836. (Cited by DlETERICH, "Krank. Fam. 
Syph.," 1S42, p. 147). 
Case, chancre in site of a razor wound. 
Van Buren, W. H. New York. (See Keyes). 



37 8 SYPHILIS INSONTIUM 

Van Deurs. 

Journ. de med. et de chir., June, 1835.* (Boeck, "Traitede la Radesyge," 

P- 47)- 
Description of syphiloid of Jutland. 

Van Dugteren and Van Walsem. Amsterdam. Clinic of Prof. D. Van 

Haren-Noman. 
Mitth. aus der Klinik, etc., Bericht ii. d. in d. J. 18S6-7, etc., Haarlem, 
1889. 

1) Statistics: chancre of lip, 35; breast, 3; nose, 1; tonsil, 1; of 372 
syphilitic women and children, 131 or 35 per cent, were innocent. 

2) Case, chancre of tonsil, child, from syphilitic father. 

3) Two cases, chancre of lip,' brother and sister, from mother. 
Van Harlingen, A. Philadelphia, U. S. A. 

Philadelphia Med. Times, 1884-5, xv -> P- 8o - 

1) Case, chancre lower lip, in woman of 52, from a bite. 

2) Chancres of upper and lower lip, in girl of 14, said to be from a bite; 
this girl infected her infant sister, who then infected her mother and 
brother. 

3) Case, chancre, angle of mouth, man 30 years old. 

4) Case, chancre lower lip, woman 23 years old, probably from 
kissing. 

5) Case, chancre upper lip, in woman of 24, source unknown. 

6) Case, chancre, angle of mouth, man of 43, from a bite by a 
prostitute. 

7) Case, chancre of tongue, probably from kissing. 

8) Case, chancre of face, in man of 53, contracted in shaving. 

9) Case, chancre nipple, young woman, from bite by young man with 
sore mouth. 

10) Case, chancre lower eyelid, in a man, site of a blow; tumefaction 
punctured by a penknife and sucked by a friend with mucous patches 
in the mouth. 

Vanier. 

(Cited, without reference, by Jaffe, " Die rituelle circumcision," Leipzig, 
1886). 
Case of circumcision syphilis. 

Vanmerris, H. C. 

" De la transm. de la syphilis par 1' operation de la vaccine." These de 
Strasbourg, 1863, (pp. 41.)* 

Van Swieten, G. Vienna. 

" Abhandlung von der Liebesseuche," ixankturt, 1727, p. 20. 
Case, infection of a nursling by a diseased wet-nurse. 

Vassal, P. A. Paris. Hop. des Veneriens. 

" Mem. s. 1. transm. d. virus vener. d. 1. mere a 1' enfant." These de Paris, 
1807. 

1) Case, the second child of syphilitic parents infects nurse (Legrand, 
Obs. IV.). 

2) Case, similar, second child infects nurse (Obs. VIII., IX). 

3) Case, prematurely born child lives long enough to infect nurse (Case 
of Gilbert's; Obs. VII.). 

Vaughan, B. E. New York. 

Trans. N. Y. Dermatolog. Soc, 218th meeting (Journ. Cutan. and Genito- 
Urin. Dis., Vol. XL, 1893, p. 28). 
Case, chancre front part of scalp, in married man of 35, inoculated pre- 
sumably by finger-nail wound, in a fight. 

Velpeau, A. Paris. 

Memoir of the Academ. of Medicine on Syphilization. Discussion, 1852, 
p. 302, et seq. 



ANALYTICAL BLBLLOGRAPHY 379 

1) In debate Velpeau recapitulates certain of Ricord's cases (p. 321), 
and cases of Bardinet, soon afterwards published. 

2) Case of Henri-de-Saint-Arnould (p. 363, q. v). 
Velschius, G. H. (See Welsch). 

Observ. med. episag. cent., etc., Ulmae, 1667. (Cited by Plouquet). 
Lactation syphilis. 
Velten. 

(Cited by Ruthenburg "De syph. ab aliis atque a part, genital.," Diss., 
Bonnae, 1830). 
Domestic epidemic, spread among families ; introduced by a child who 
had been at a religious festival (Obs. VI.). 
Venot, J. Bordeaux. Hop. St. Jean. 
L'Union med. Paris, 1852, p. 472. 
Case, nursling infected by nurse. 
Vercelloni, J. Rome. 

" De pudend. morbis. . . ." Astae, 1716, p. 205 (Cited also by Van Swieten, 
" Abhandl. von d. Liebesseuche," Frankfurt, 1727, p. 21). 

1) Epidemic involving an entire village, which began from two nurslings. 
(See Epidemics). 

2) Case, chancre of hand, cited by Lancereaux (q. v.). 
Vere-Delisle. Paris. 

Acad. gen. de med., Paris, April, 1830, p. 566. 

Case, chancre of anus in infant, whose mother was infected three 
months after delivery. 
Verneuil, A. Paris. Hop. de la Pitie. 

Bull, de la soc. de chir., July 25, 1855. (Cited by Tardieu " Etude med.- 
leg.," etc. Paris, 1879, p. 216). 

1) Case, chancre left breast, nurse from nursling. 

2) Case, infant of above nurse, infected by nursing. 
Gaz. des Hopit., 1879, p. 106. 

3) Case, acquired infantile syphilis. 
L'Union med., Paris, 1888, p. 297. 

4) Case, nurse infected by nursling. 

5) Case, nurse infected by nursling, infects her two children. 
Veslin, L. Paris. Hop. St. Louis. (Externe). 

Statistics of extra-genital chancre, 1888: 26 cases (15 males, 11 females); 
chancre of lip, 10 (lower, 9; upper, 1); tonsil, 4; tongue, 2; eyelid, 1 ; 
breast, 2; abdomen, 2; thigh, 1; anus, 4. 
Viani. Piedmont. 

Gaz. med. Lombard., 1849. (Journ. de med., Paris, 1849, IV. , p. 874). 
Family epidemic, nursling infects three nurses, and one of them in- 
fects another nursling; the first child then infects two uncles by 
vaccination. 
Vicherat. Nemours. (See Depaul 5 ). 

Victorius. Padua. Univ. Prof, of Medicine. 
" Liber de morbo gallico." Florentine, 1551. 
Case, chancre of lip, young man from kissing. 

Vidal, A. (de Cassis). Paris. Hop. du Midi. 

Traite des malad. veneriennes, Paris, 1S53, p. 522. 

Four children, in weaning house, infected through tin cup, by infant 
who had been infected by nurse. 

Vidal, Emfle. Paris. Hop. St. Louis, Surgeon. 
Annales de Derm, et de Syph., Paris, 1SS9, X. 

1) Case, chancre on dorsum of tongue, man aged 27 (p. 213). 

2) Case, chancre lower lip, girl 21 years, from speaking-tube (p. 337). 
(also in Journ. de med., June, 1SS9). 



380 SYPHILIS INSONTIUM 



3) Case, chancre right side, tip of tongue, man aged 26 (p. 455). 

4) Case, chancre left tonsil, wife of the above (p. 454). 
Viennois, A. Lyons. Hosp. de l'Antiquaille. (Service of Rollet). 

" Recherches sur les chan. prim, et les accid consec. prod, par la contag. 
de la syph. second." These de Paris, i860. 

1) Ten cases, nurses infected by nurslings ; one infected her husband 
by coitus, another her daughter, by breast-drawing. 

2) Case, chancre lower lip, glass-blower (p. 65). 

3) Case, chancre both lips, from kissing husband, infects 

4) Child, 7 years, chancre tonsil, from using spoon, and 

5) Another son; no particulars given (p. 66). 

6) Mention of several infections from tattooing at Val-de-Grace (p. 29). 
Archives generales de med., Paris, June, i860 etseq., (Reprinted in " Syph. 

vaccinale," Acad, de med., Paris, 1865, pp. 220-358). 

7) A very extensive study of vaccinal syphilis, with very many valuable 
quotations and references, but giving no orginal cases. 

"De la syph. contracted par les verriers dans 1* exercise de leur prof.," 
(Extrait du conapt-rendu, med.-chir. de Rouen, 1863). 

8) Four cases, chancre of lip, in glass-blowers ; one excised for epithe- 
• lioma. 

9) Three cases, chancre tonsil, in glass-blowers (one reported eight others 
infected) ; one infected his wife. 

10) Case, chancre of fauces, glass-blower. 

11) Three cases, infection of glass-blowers. 

12) Epidemic at Rive-de-Gier, 1862, twenty victims. (See Epidemics). 

13) Cases of Bazin, Hervier, Lagrange, Rollet, q. v. 

Vigla. 

L'Union med., Paris, 1864, No. 129, p. 217. 
Case, chancre from Eustachian infection. 
Viguier, E. Hop. du Midi. (Interne, service of Mauriac). 

41 Etude sur les chancres infect, extra-genit.," These de Paris, 1888. 

1) Case, chancre, free border of left upper eyelid, female, cause 
unknown. 

2) Case, chancre inner angle of eye, from husband's kiss. (Service of 
Abadie, q. v.). 

3) Case, chancre nose, upper and lower lip, male. 

4) Case, two chancres of cheek, from bite in play. 

5) Five cases, chancre of lips. 

6) Three cases, chancre of tongue. 

7) Case, chancre inside right cheek, from mouth-piece of cornet. 

8) Two cases, chancre tonsil and throat ; one from a flute. 

9) Case, chancre of chin, from razor-cut. 

10) Case, chancre neck, level of thyroid, male aged 24. (Notes by 
J. Huguet). 

11) Case, chancre over mastoid bone, male aged 20. (Notes by J. 
Huguet). 

12) Chancre of anus, 3 ; thigh, 1 ; calf of leg, 1 ; finger, 2. 
Villard. Lyons, France. 

Lyon Medical, 1890, LXV., p. 196. 
Case, chancre lower lip, glass-blower; fellow-workman blowing tube 
immediately before patient, had mucous patches in mouth ; three 
other workmen also acquired syphilis from same man. 
Villeneuve. Marseilles. 

Marseille Medical, 1890, No. 6, p. 366. 

Case, chancre lower lip, man 25 years old, mode of infection unknown. 

Vincent. 

"Expose clinique des maladies des Kabyles," Paris, 1S62. (Lancereaux, 
" Traite," etc., p. 42). 



ANALYTICAL BIBLIOGRAPHY 381 



Violet,J. 

" Etude pratique sur la syph. infantile," These de Paris, 1874. 

1) Case, child of 6 years infected by father, contact in bed (p. 28). 

2) Case, chancre of breast, infected by nursling (p. 35). 
Voege, F. H. Wiirzburg. Poliklinik, Children's Diseases. 

" Ueber S\-philis der Kinder." Inaug. Dissert., Wiirzburg, 1S69. 
Case, infant of 4 months, infected by woman, with whom it slept. 
Vvedensky, A. A. St. Petersburg. 

Proceed. Russ. Syph. Derm. Soc, 1SS5, p. 12. (Provin. Med. Journ., 
1S87, p. 422.) 
i)Case, three chancres, left forefinger, man aged 35, from a bite. 
Yratsch., 1889, p. 980. 

2) Case, chancre right temporal region, man, hospital infection. 
Vyshogrod, I. Vladikavkaz, Russia. 

Russkaja Meditzina, Dec. 17, 1SS9, p. 729. 

Case, chancre palmar surface right little finger, at meta-carpo-phalang. 
joint, in hospital waiter, aged 24. 
Walch, F. A. Jena. 

" Praktische Darstellung d. vener. Krank," Jena, 1S11 (Cited by Wendt, 
"Die Lustseuche in alien ihren Richt.," Breslau, 1825, p. n). 
Obstetrical epidemic, over 50 infected (See Epidemics). 
Wallace, Wm. Dublin. 

" Lectures on Yen. Dis," Lancet, London, 1835-6 (Behrend's Syphilidolo- 
gie, I., 1S39, p. 193). 

1) Case, boy 8 years old, infected by mother. 

2) Case, feeble minded boy of 17, infected by mother, probably in throat. 

3) Case, chancre of lip, man, from pipe of comrade. 

4) Description of " Morulus " or " button scurvy" of Ireland, (pp. 475, 

485). 
Medico-Chirurgical Trans., Vol. XIII., 1S38, p. 469. 

5) Three cases of Morula; one illustrated by a plate. 
Waller, A. Prague. General Hosp., Director. 

PragerVierteljahrreschrift, 1S51, t. I. (Annales des mal. de la peau et de la 
syph., t. III., 1S50-51). 

1) Infection of two-year-old girl by nurse, (p. 177.) 

2) Infection of three infants, 2 to 3 years of age, by their respective 
mothers (p. 178). 

3) Three cases, infection by pederasty in boys ; one infects younger 
brother, by contact in bed (p. 178). 

4) Case, nurse from nursling (foundling), infects 

5) Her own infant (p. 180). 

6) Mother of above nurse, aged 66, chancre left cheek and side of neck, 

from contact in carrying grand-child (p. 1S0). 

7) Woman infected by foundling at breast; communicates the disease to 
her own four children (p. 180). 

(Reported by Suchanek q. v. service of Waller, 1S53). 

8) Case, nurse infected by nursling. 
PragerVierteljahrreschrift, 1S59, p. 153. 

9) Infection of servant-maid, from her employers (Obs. 16). 
10) Case, chancre of lip, in a servant-maid. 

Walter, L. Wiirzburg. Julius Hospital. (Interne or pupil). 

"Ueber einige selt. Falle v. Syph.," etc. Inaug. Dissert., Munncheh, 

1S80. 

1) Case, chancre, lower lip in a girl, bitten by a stranger. <( )bs. I., ]>. 1 1 1. 

2) Case, chancre lower lip, in student, from kissing. (Obs. 11., p. 
(Two following eases seen at Munich in Hospital). 

3) Case, chancre lower lip, in servant girl, kissing. (Obs. III., p. 

4) Case, chancre lower lip, in man, no history. (Obs. IV, p. 17'. 



382 SYPHILIS INSONTIUM 

Watson. Stourport, England. 

Case, lactation syphilis, nurse infected at nipple. (See Abernethy). 
Watson, Spencer. London. Kings College Hospital. 
Lancet, London, 1S65, I., pp. 119, 519. 

1) Case, chancre cheek, from husband with buccal lesions. 

2) Case, chancre lower lip, female aged 19. (See Mason). 
Medical Times and Gaz., 1S81, I., p. 428. 

3) Case, chancre nostril, nurse from nursling. 
British Med. Journ., 1881, I., p. 721. 

4) Case, chancre lower eyelid, source of infection unknown. 
Watson, W. London. 

Trans. Coll. Physicians, III., 1785, p. 325. Also see "Lectureson Syph.," 
etc. Phila., 1875, p. 20. 
Case, inoculation of syphilis by transplanting a tooth. (Given also by 
Hunter, and Swediaur). 
Wecker, L. de. Paris. 

"Traite compl. d'Ophthal.," Paris, 1880, Vol. I.; de Wecker and Land- 
oldt. (Cited by De Beck, q. v.). 

1) Case, chancre left lower eyelid (p. 69). 

2) Case, chancre conjunctiva left eye, from kissing (p. 409). 

3) Case, chancre conjunctiva left eye, from kissing. 

4) Case, chancre conjunctiva right eye, from cleaning eyelids with 
spittle, by mother. 

Wedekind, Geo. 

" Fragmente iiber d. Erkentniss d. ven. Krank.," 1790. (Girtanner, No. 
1855, and Clossius). 
Cases, infection of midwives (p. 21). 
Wegeler. 

Med. Zeit. d. Verein d. Heilk. in Preuss., 1850. (Fournier, " Syph. vacc," 
Paris, 1889, p. 197). 
Epidemic of vaccinal syphilis ; 19 infected at K., in 1849. (See Epidemics) # 
Weiger. Strasbourg. (See Wolff). 
Weil, A. Heidelberg. Univ. Prof. Dermatology and Syphilis. 

Wiener, med. Presse, 1877, P- 1483- (Archives of Dermatology, New York, 
Vol. V., 1879, p. 92). 

1) Case, chancre root of nose, new-born child; claimed infection per 
partum. 

"Ueber. . . . Vererbung der Syph." Volkmann's Samml. klin. Vortr., 
No. 130, 1878, p. 892. 

2) Case, chancre both breasts, nurse from nursling; infects own child 
and husband. 

Weinberg, J. Vienna. 

Siczungsber. d. K. K. Gesell. d. Aerzte zu Wien, Nov. 8, 1878. 

1) Case, chancre, cheek, from room-mate, nail inoculation. 

2) Case, chancre of tongue, woman, source unknown. 

Mittheil. d. Wiener med. Doct. Colleg., V., No. 1, 1879 (Wien. med. Presse, 
1S79, p. 21). 

3) Case, infection per os, father by son, common use of utensils. 

Welsch. (See Velschius). 

Wendt, J. Breslau. 

" Die Lustseuche in alien Richtungen," etc., 3d edit., Breslau, 1S25. 

1) Epidemic of obstetrical syphilis, from chancre on finger of midwife ; 
many infected in one of provinces of Silesia, (p. 11). (See Epidemics). 

2) Epidemics of circumcision syphilis in two towns in Silesia ; many in- 
fected (p. 11). (See Epidemics). 

3) Case, chancre cheek, in attendant on a syphilitic, whom he had car- 
ried in arms, with his cheek resting on his own (p. 214), 



ANALYTICAL BIBLLOGRAPHY 383 

Werfel, F. G. 

"Dissert. Inaug. med. inquirens qusestionem au morbi, qui dentium trans- 
locationem sequuntur verier, sint, nee ne ?" Halae 1792, (pp. 30).* 
Wherry, G. Cambridge, England. Univ. Prof, of Surgery. 

Trans. Ophth. Soc. United Kingdom, 1S92, p. S (Brit. Med. Journ., 18S2, 
I., p. 120). 
Case, chancre conjunctiva of lower eyelid. 
White, Jas. C. Boston. Prof. Dermatology, Harvard University. 
Boston Med. and Surg. Journ., February 4, 1S92, p. 107. 

1) Statement: has notes of 15 cases of physicians inoculated in dis- 
charge of professional duties, and knows of other cases. 

2) Once saw midwife, who had delivered 32 women, with an open 
primary lesion on ringer. 

White, J. Wm. Philadelphia. Surgeon Univ. Hospital. 
Univ. Med. Magazine, 1890, II., p. 263. 

Case, two chancres of left cheek shown by Mr. Frederick Treves, of 
London. 
Whitehead. Manchester, England. 

Third Report Clinical Hospitals of Manchester, 1859. 

Fourteen cases alleged vaccinal syphilis, between 1S56-1S59, 
Whitehead, H. R. England. Surgeon British Army. 
British Med. Journ., 1SS9, II., p. 601. 

Five cases, syphilitic infection from tattooing (out of a dozen operated 
upon) in Landour, India ; tattooer had mucous patches on tongue and 
gums, and used saliva to cleanse the surface from blood, when water 
was not accessible. 
Wibmer, C. Munich. 

"Das Spyrokolon ; eine neue Krankheit im nordlichen Griechenland." 
— Schmidt's Jahrbiicher, 1S41, XXX., p. 305. 

1) Report of 20 cases of " Spirocolon." 

Schmidt's Jahrb., 1S41, XXX., p. 3o6(Hirsch, Handb. der hist.-geograph. 
Path., Stuttgart, 1SS3, p. 66. 

2) A mention of " Frenga." 

Widmann, M. Isny, Suabia. 

(Letter published by Horst, q. v.). 

Epidemic from cupping, at Yvindsheim, 1624. (See Epidemics). 

Wiethe, Theodore. Vienna. First Asst. to Dr. Jaeger. 
Allg. Wien. med. Zeitung, 18S2, No. 23, p. 249. 

1) Case, chancre right lower eyelid, girl aged iS, from blow during a 
dance (wood-cut illustration). 

2) Case, chancre eyelid. (Service of Arlt, q. v.). 

Wigglesworth, Edw. Boston, U. S..A. 

Archives of Dermatology, New York, 1S79, p. 374 and New York Med. 
Journ., 1884. 

1) Case, chancre tonsil, physician, from inflating lungs of new-born. 
Boston Med. and Surg. Journ., Feb. 4, 1892, p. 116. 

2) Refers to a midwife who infected 17 women in Boston, and then went 
to Xova Scotia and infected several more there. 

Wilcox. CJ. S. Military Service, Surgeon. 

(Observation published by ARTHUR, q. v.). 

Epidemic of syphilis from tattooing; 26 soldiers infected. (See Epi- 
demics). 

Wildbore, F. Brighton, England. 

British Med. Journ., 1861, I., p. 464. 
Case, syphilis from secondary inoculation, " infection of wife and 
offspring." 



3^4 SYPHILIS INSONTIUM 

Wildhagen, F. C. Drammen, Norway. City Physician. 

" Sypilisation udfort i Drammens Sygchuus," Norsk. Mag. for Laegevid., 
Christiania, i860, p. 938 (Behrend's " Syphilidologie," N. R., 1862, p. 

325). 

1) Case, chancre upper lip, female aged 19. 

2) Case, chancre upper lip, female aged 30, room-mate of previous 
case. 

3) Case, dry-nurse, aged 36, infected by infant. 

4) Case, chancre left breast, nurse from nursling. 
Wilks. London. Guy's Hospital. 

Phila. Med. News, Vol. LX., 1892, p. 264. (Reported by Robbins). 

Case, infection of a surgeon who cut finger while operating upon a 
syphilitic. 
Willemin. 

Memoir sur le Bouton d'Alep., 1854.* 
Willemoes. 

" Af handling om den i Skotland herskende Sibbens v. Syphilis insontium 
med. Hensyn tildennorske Radesyge," Biblioth. f. Laeger., Kjpbenh., 
1810, II., 25-42* (quoted by Boeck, " Traite d. 1. Radesyge," i860, 
p. 49). 
A comparison of Sibbens with Radesyge. 
Willi, J. V. Colmar. 

"De morbis castrensis internis," Hafnise, 1679 (Girtanner, No. 525). 
Case, syphilis acquired by kissing. 
Williams, A. 

St. Louis Med. and Surg. Journ., 1881, XL., p. 424. 

Case, chancre right middle finger, man aged 48, alleged to be from 
operation on fistula in a horse. 
Willams, R. Liverpool. 

Liverpool Medico-Chirurgical Journ., 1884,1V., p. 195. 

Case, chancre conjunctiva bulbi ; nurse infected by nursling, her niece. 
Wills, D. 

' 4 Remarks on Sibbens.'' Month. Journ. Med. Sci., Edmb., 1844, IV., 
pp. 282-289, also > Dublin Quart. Journ. Med. Sci., 1844, XXV., pp. 
346-354.* 
Wilson, Wm. 

Journal of Cutaneous Medicine, 1871, p. 259. 

1) Case, infant infected by nurse, its aunt, and infects 

2) Its mother, chancre of breast, and 

3) Three cases, two sisters and brother, probable chancre of fauces, 
from spoon feeding. 

Wiltshire. London. Royal Infirmary for Sick Children. 
Report of British Admiralty Commission, 1867, p. 364. 
Nurses infected by nurslings. (No exact data supplied). 
Windheuser, E. Miinstermaifeld. 

"Ueber Initialsclerose am Kinn." Inaug. Dissert., Bonn, 1890. 
Case, chancre of chin, in man of 60, from razor-cut (p. 22). 

Winslow, R. Baltimore, U. S. A. 

Maryland Med. Journ., 1883-4, X., p. 731. 

Case, chancre of both breasts, from sucking by syphilitic husband. 

Winters, J. E. New York. 

New York Med. Record, Vol. XXX., 1886, p. 510. 

1) Case, nursling infected by nurse. 

2) Case of Donne (q. v.). 

Wirpscha, G. F. Ssamara, Russia. 

(Cited in Archiv f. Derm. u. Syph., 1889, p. 255). 



ANALYTICAL BIBLIOGRAPHY 3 8 5 



Statistics: of 5396 cases of syphilis, 249 (4.61 per cent.), were extra- 
genital; of these, males, 50; females, 99; children, 100. 
Woillez. Paris. Hop. Lariboisiere. 

(Reported by Ory, q. v. " Contrib. . . . syph. malignes precoc," These 
de Paris, 1875). 
Case, chancre upper lip. 
Wolf. f 

(Reported by Ruthenberg q. v. " De syph. ab aliis atque a part, genit.,"' 
1830). 

1) Case, child infected by dry-nurse, from chewing its food. 

2) Case, mother of above child, infected per os. 

Wolfe. Glasgow. Anderson College, Prof, of Ophthalmology. 
" Diseases and Injuries of the Eye," 1882 (2d edit). 
Two cases, chancre of the eyelid. 
Wolff, A. Strasbourg. 

"Syph. hered. tarda." Volkmann's Samml. klin. Vortr., 1886, No. 273. 
Case, chancre index finger, in midwife (service of Weiger) p. 2517. 
Wood, Wm. C. Gloversville, N. Y. 

New York Med. Journ., 1888, XLVII., p. 184. 

1) Case, chancre of finger in a barber. 

2) Case, chancre knuckle, from blow on mouth of a syphilitic (personal 
communication). 

Wright, W. 

"Syphilis in Canada, as denoted by Sibbens." Med. Chron., Montreal, 
1855, II., pp. 299-303.* 
Yakimovitch, N. N. 

Russian Derm, and Syph. Soc. Meeting, Jan. 3, 1891 (Annales de Derm, 
et de Syph., 1891, p. 237). 
Case, chancre right tonsil, source unknown. 
Yvaren. (See Rognetta). 
Zabolotski. Moscow, Russia. 

Med. Obosrenaie, 1884, No. 5, p. 466 (Cited by De Beck, q. v.), also (Revue 
gener. d'Ophthalm., 1884, p. 325). 
Case, chancre of right upper eyelid, from kiss, male 33 years of age. 
Zakharevitch, V. M. Kharkov, Russia. 

Trans. Kharkov Med. Soc, 1887, Vol. II., 1888, p. 10 (St. Louis Med. and 
Surg. Journ., 1889, LVL, p. 106). 
Eighteen cases of syphilitic infection through promiscuous use of 
spoons, tumblers, etc. ; in most of the cases, the primary lesion was 
in the oral or faucial region. 
Zallonis, John A. Syra, Greece. 

Bull, de l'Acad. de med., Paris, 1867, P- 1017. (See Depaul). 
Two cases of vaccinal syphilis. 
Zarewiez. Krakau. Hosp. St. Lazarus. 

Eight cases, chancre female breast. (See Gluck). 
Zecchinelli. 

Annali universali di medicina, Nos. 39,335* (Cited by Rollet "Traite,'' 
etc., 1S66, p. 464). 
An original account of Facaldina. 
Zeisse. 

Allgem. Wiener mcd. Zeit'g, 1877 (WlNDHEUSER " Initialscl. am Kinn," 
Inaug. Dissert., Bonn, 1890, p. 19). 
Two cases, chancre of chin, one following a bite, the other from a kiss. 

Zeissl, Hermann. Vienna. Univ. Prof, of Syphilis. 

Wochenbl. der K. K. Gesells. d. Aerzte in Wien, 1S61, Nos. 48, 49. (Lchrb. 
der Syphilis, 3d Edit., Stuttgart, 1S75, p. 25). 

26 



386 SYPHILIS INSONTIUM 



i) Case, chancre of lip, in a soldier. 

2) Case, chancre of arm, physician, inoculation from above case. 

3) Case, Eustachian-sound infection, chancre of fauces, perforating 
velum palati, (Part II., p. 37). 

4) Case, chancre chin, man aged 22. 

5) Case, chancre right cheek, from kiss. 

6) Case, chancre right index finger, back of last phalanx, attendant aged 
65, in Foundling Asylum (plates of last three). 

Allgem. Wien. med. Zeit'g, 1877, p. 309 (De Beck, q. v., p. 7). 

7) Statistics: among 40,000 syphilitic patients, two cases chancre of 
eyelid. 

Allgem. Wien. med. Zeit'g, 1878, Nos. 2-7. 

8) Case, chancre ball of left thumb, man aged 28, from bite. 

9) Case, chancre left breast, from bite. 

(Reported by Finger q. v. Archiv f. Derm. u. Syph., 1881, p. 273). 

10) Case, chancre upper lip, soldier aged 50. 
Allgem. Wien. med. Zeit'g, 1882. 

11) Case, chancre of lip, (p. 54). 

12) Case, chancre of tongue, (p. 314). 
Archiv f. Derm. u. Syph., 1884, p. 547. 

13) Infection of Prof. Zeissl, May, 1870; chancre of finger from wound in 
opening bubo. 
Zeissl, Maximilian. Vienna. 

Allgem. Wien. med. Zeitung, 1882, p. 396. 

1) Case, chancre of nipple in mother, from her own hereditarily syphi- 
litic child ; exception to Colles' Law (case of Luth q. v.). 

Archiv f. Derm. u. Syph., 1887, p. 298. 

2) Personal account of "Skerljevo" mostly late syphilis, frequently 
with history of being acquired in early life.' 

Zeleneff. 

London Med. Recorder, Oct. 1890, p. 397. 

1) Nine cases, extra-genital infection. 

Vratsch., 1891, p. 212 (Journ. of Laryngology, July, 1891, p. 277). 

2) Case, chancre of lip, m a soldier. 

3) Case, chancre of the tonsil in a man. 

Zewecke, V. A. St. Petersburg. Clinic of Prof. Tarnowsky, (q. v.). 

Russkaja Medizina, 1886. (Cited as Leweke, in Monatsh. f. prakt. Derm., 
1888, p. 314). 
Two cases, chancre of tonsil, Eustachian-catheter infection. 

Zingalis. 

(Cited by Merz, Journ. des mal. cutan. et syph., Vol. II., 1890, p. 56). 
Case, infection of mother by child ; exception to Colles' Law. 

Zucker, J. 

Zeitschrift f. Ohrenheilkunde, 1884, p. 167. 
Case, chancre of external ear from tongue. 
Zuriaga, M. Valencia, Spain. 

La Cronica Medica, 1891, XIV., p. 321. 

A study of vaccinal syphilis, citing cases from Signorini, and Perrin. 

Zwetitch, M. 

" Sur la chancre syph. hypertroph.," These de Paris, 1S84. 

1) Four cases, chancre of lip (Guibout, 3; Fournier, i). 

2) Three cases, chancre of chin (Fournier). 

3) Two cases, chancre of cheek (Barthelemy, and Mauriac). 

4) Case, chancre of finger (Mauriac). 



INDEX 



Aalborg, epidemic from glassblowing at, 
122. 

Abo, epidemic from cupping at, 122. 

Abortion, effect of syphilis in producing, 198. 

Abscess, infection by opening, 191. 

Abyssinia, syphilis in, 10. 

Acarus scabiei, its role in the communica- 
tion of syphilis, 112, 194. 

Accidental professional wounds, infection 
by, 190, 191. 

Accouchement, epidemics of syphilis from, 
115-117, 119, 122, 123, 177, 178. 

Accoucheurs, infected with syphilis, 20, 
28, 174, 175- 
syphilis conveyed by, 177, 178. 

Aerial transmission of syphilis, 19, 20, 
169, 176. 

Afghanistan, syphilis in, 9. 

Africa, syphilis in, 9, 10, 122. 

Ages of patients with extra-genital chan- 
cres, personal cases, 38. 

Aikin, epidemic from vaccination at, 121. 

Alaska, syphilis in, 1 1. 

Aleppo Evil, 17, 136. 

Alexandria, epidemic from vaccinatien at, 
122. 
syphilis in, 9, 10. 

Algiers, epidemic from vaccination at, 122. 
syphilis in, 9. 

Alsembourg, epidemic from breast-draw- 
ing at, 118. 

Altorf, epidemic from cupping and phleb- 
otomy at, 115. 

Amboyna Pustule, 17, 127, 128. 

American Dermatological Association, 
sUtistics of syphilis for 14 years, 200. 

Anal and peri-genital chancres, 25, 30, ^^. 

Andernach, epidemic from vaccination at, 
117. 

Antilles, syphilis in the, 11. 

Antiquaille, hospital statistics from, 25. 



14S. 



Antiquity of syphilis, 2. 

Anus, chancre of the, 20, 30, 147 

Arabia, syphilis in, 9. 

Arkansas, epidemic from vaccination in, 120. 

Arm, fore, chancre of, 30, 37, 104, 151, 171. 

Armenia, syphilis in, 9. 

Army, United States, syphilis in the, 199. 

Artificial flower makers' syphilis, 18, 155.. 

teats, as a cause of syphilis, 19. 
Asia, syphilis in, 8. 

Minor, syphilis in. 9. 
Assayers' syphilis, 18, 154. 
Astragal and Calibera, epidemic 

lactation at, 121. 
Attendants, infection of, 19, 27, 166 

176. 
Auray, epidemic from vaccination at, 
Australasia and Oceanica, syphilis in, 
Austria, epidemics of syphilis in, 115, 117 

119, 121. 
Austro- Hungary, syphilis in, 7, 30. 



froi 



172, 



121. 

12. 



Axilla, chancre of the, 
abscess, 191. 



from 



opening an 



Bamberg, epidemic from cupping at, 115. 
Bandages, infection by, 20, 14S. 
Hunk-notes, infection by, 156. 
Bardella and Bergona, epidemic from vac- 
cination at, 122. 
Bassoon, infection from, 154. 
bathing suit, infection from, 105, 106, 147. 
Bavaria, syphilis in, 7, 1 15, 118. 
Hed, infection by contact in, 153. 
J Bedding, infection from, iS, 1 |S. 

Beer-mug, infection from, [44. 
j Belgium, epidemic from breast-drawing 
in, 118. 

and Holland, syphilis in, 6. 

Beloochistan, syphilis in, 9. 
Ben eshoff disease, S. 

Biskra Bouton, 17, 136. 



* This index does not refer to material in tin- 
be consulted for complete information. 



Synopsis' or " Bibliography, which should also 



3 88 



INDEX 



Biting, infection from, 18, 23, 151, 152. 
Blood, infection by the, 23. 
Blood-letting, epidemic of syphilis from, 

"5- 

Blowpipe, infection from, 154. 

Blunt instruments, infection by, 192, 193. 
Boala lumeasca, or le mal qui court le monde, 

6, 137. . 
Bones, evidence of syphilis, furnished by 

prehistoric, 3, 11. 
Boutons d'Amboine, 17, 127, 128. 
Brazil, syphilis in, 11. 
Breach of promise, syphilis a complete 

defence for, 207. 
Breast, chancre of the, 25, 30. 

countries where most common, 31. 
in young married women, 84-87. 
personal cases, 37, 84-87. 
relative frequency, 31. 
from breast-drawing, 180- 1 82. 
from kissing, 86. 
from nursing, 84-86, 159, 160. 
from scratch, in a male, 152. 
from soiled dressings, 148. 
drawing, epidemics of syphilis 
from, 1 1 6- 1 18, 120, 122, 180- 
182, 202. 
infection from, 20, 176, 180-182. 
Brephotrophic syphilis, 19, III, 142, 158- 

171. 
Brive, epidemic by accouchement at, 122. 
British America, syphilis in, 1 1. 
Brunn, epidemic from cupping and blood- 
letting at, 115. 
Brush, electric, infection from, 193. 
Buccal cavity, chancre in, 25, 30. 

countries where most common, 31. 
chancre from conductor's whistle, 

155. 

from nursing, 86. 

contact, infection from, 150-152, 

168, 176, 178-183. 

infection in industrial relations, 

153-155. 

through an open wound, 178-180. 

without open wound, 180-183. 
Bugle, infection from, 154. 
Buttocks, chancre of from contact in 
sleep, 170. 

from incision of furuncle, 191, 192. 
Button Scurvy, or Morula of Ireland, 132. 

Cadaver, syphilis contracted from, 20, 
173. 
Cane, infection from a, 18, 150. 
Caneotica, 17, 136. 
Capistrello, epidemic from lactation at, 6, 

119, 138, 161. 
Cardeillac, epidemic from vaccination at, 
121; 



Carrying or supporting, infection by con- 
tact in, 18, 19, 153, 170, 171. 
Cashiers' syphilis, 18, 155, 156. 
Castellafiume and Roccaviva, epidemic 

from lactation at, 121. 
Castellanza, epidemic from chewing pap at, 

166. 
Causes of the spread of syphilis, 107, 108. 
Caustic-holders, infection from, 193. 
Cazorezzo and Ubaldo, epidemic from 

lactation at, 120. 
Central Africa, syphilis in, 10. 
Cephalic contact, infection from, 176. 
Chalice, infection from the, 146. . 
Chancre, appearance aDd characters of, 
22. 
as a source of the virus, 23. 
Hu Sahara, 17, 136. 
Charles VIII., syphilis spread by the army 

of, 114. 
Chavanne-Lure, domestic epidemic at, 1 1 8. 
Cheek, chancre of the, 25, 30. 

personal cases, 37, 91-95. 

relative frequency, 33. 

from attendance, 176. 

from a bite, 151. 

from contact with a syphilitic 

infant, 171. 
from a pinch, 152, 153. 
from razor wounds, 92-95, 191. 
from a scratch, 152. 
from sucking a wound, 178, 179. 
from a towel, 148. 
Chewing food, infection from, 19, 166. 
Chin, chancre of the, 25, 30. 

personal cases, 37, 97-99. 
relative frequency, 33. 
from kissing, 97. 
from razor cut, 97, 98. 
China, syphilis in, 8. 
Chinese literature of syphilis, 2. 
Chirurgical manipulations, syphilis con- 
veyed in, 177. 
Cigars and cigarettes, infection from, 45, 

.5 2 » 54, 5 6 > 58-6o, 62, 146, 147. 
Circumcision, epidemics from, 1 1 7, 118, 
121, 122. 
as a means of syphilitic infection, 

19, 29, 30, 179, 180. 
syphilis, how first known, 201. 
relative frequency, 33. 
Clandestine prostitution, effect upon, by 

examination of the men, 206. 
Clarionette, infection from a, 154. 
Classification of the modes of infection of 

syphilis, 17-21. 
Clerks, syphilis in, 18. 
Cloth, infection from piece of, 167. 
Clothes dealers' syphilis, 18. 
Clothing, infection from cast off, 156. 



INDEX 



3*9 



Coblenz, epidemics from lactation and vac- 
cination at, 117, 118 

Coccyx, chancre over, in man of 45 years, 
personal case, 105, 106. 

Coins, infection from, 155, 156. 

Coitus preternaturalis, infection from, 64-66. 

Colles' law, definition of, 159. 

exceptions to, 19, 23,159,160,221. 

Cologne, epidemic from breast-drawing at, 
118 

Columbus, syphilis imported by the fol- 
lowers of, 1 14. 

Combs, infection from, 19, 149, 167. 

Commodes, infection from, 18, 149. 

Communion cup, infection from, 146. 

Conceptional syphilis, case of, 75, 76. 

Conde, epidemic from breast-drawing and 
lactation at, 117. 

Conductors' syphilis, 18, 154, 155. 

Contact in arms, infection from, 171. 
in bed, infection from, 170. 

Contagious diseases prevention acts, of 
England, 8, 203, 204. 

Contagious diseases, syphilis placed in 
category of, 203-CO7.' 

Cooks, syphilis in or from, 18, 144. 

Cork, epidemic of syphilis from breast- 
drawing at, 1 16. 

Coughing in face, infection from, 20, 176. 

Countries where governments have exerted 
control over syphilis, 203. 

Courland, syphiloid of, 133. 

Cradle, infection from, 19, 167. 

Cremona, epidemic from vaccination at, 

Csomad, epidemic from vaccination at, 120. 
Cupping, communication of syphilis by. 
20, 30, 184, 185. 
epidemics of syphilis from, 7, 

115, 1 19, 121-123, 184, 185. 
and phlebotomy, relative fre- 
quency of chancre from, 33. 
Cups, infection by use of, 18, 19, 143,166. 
Cutting instruments, infection by means of, 
189-192. 

Definition of syphilis, 2. 
brephotrophica, in. 
economica, III. 
endemica, 1 1 1. 
epidemica, 1 10. 
pandemica, HO. 
sporadica, 1 1 1. 
technica, III. 
Delhi Boil, 17, 136. 
Dellys, Mai Kabyle at, 132. 
Demography of syphilis, 107-113. 
Denmark, syphilis in, 7, 118, 122. 

Norway and Sweden, statistics of 
extra-genital chancres from, 30. 



Dental instruments, infection from, 19, 20, 

90, 91, 190. 
Dentists innoculated with syphilis, 20, 

175- 

Diapers, infection from, 19. 
Diffusion of syphilis, modes of, 3, 4. 
Digital contact, infection by, 152, 153, 
168, 169, 174, 177, 178. 
infection in industrial relations, 

156, 157- 
in professional relations, 177, 178. 
Disease of St. Paul's Bay, 17, 128. 
Distribution of syphilis, 5, 108. 
Divisions of non-venereal syphilis, 15, 17, 

no, in. 
Domestic and social relations, infection in, 

18, 143-145. 
Domestic transmission of syphilis, 18, 27. 

epidemics from, 118, 123. 
Drawing instrument, infection from, 150. 
Dressings, infection from surgical, 148, 193. 
Drinking glasses, infection from, 18, 143- 

145, 166. 
Druggists, syphilis in, 18. 
Dyke builders of Holland, syphilis among, 4. 

Ear, chancre of the, 30. 
personal case, 37, 101, 102. 
relative frequency, 33. 
from a bite, 101, 102, 151. 
Eastern Africa, syphilis in, 10. 
Eating and drinking, infection from, 18, 

143-H6. 
Economic syphilis, definition of, ill. 
Eczema, virus gaining entrance at site of, 

21, 194. 
Egypt, syphilis in, 9, 10, 122. 
Endemic syphilis, m, 124-142. 
England, epidemics of syphilis in, 116, 
120, 122, 123. 

legal control of syphilis in, 203, 
204. 
Epidemic syphilis, first record of, 113, 
114. 
rapid spread of, no. 
and endemic syphilis, reason for 
diminution in severity, 138. 
Epidemics of syphilis, earlier descriptions 
confounded with other diseases, 
1 12. 
their diminution with advancing 
knowledge, ill. 
r Europe, I 16-120. 
of Central Germany and Switzer- 
land, 115. 
in recent times, 
table of, I 15-123. 
total number of persons affected, 

123. 
over the whole world, 1 19-123. 



39° 



INDEX 



Epidemics from accouchement, 1 7, 115-117, 

119, 122, 123, 177, 178. 
from application of tongue to eye, 

17, 123, 182, 183. 
from breast-drawing, 17, Il6-Il8, 

120, 122, 180-182, 202. 

from circumcision, 17, 33, 1 1 7, 

118, 121, 122 
from cupping, 7, 17, 33, 115, 119, 

121-123. 
from eating and drinking, and 
domestic propagation, 17, 118, 
123. 
from Eustachian catheterization, 

17, 121-123. 
from glassblowing, 17, 1 20- 1 22. 
from handling cast-off clothing, 

156. 
from handraising of infants, 17, 

116, 120. 
from lactation, 6, 17, 116, 1 1 7, 

119-121, 157-166. 
from phlebotomy, 33, 1 15. 
frorr sheltering wayfarers, 1 15, 

118. 
from tattooing, 17, 119, 122, 123, 

183, 184. 
from vaccination, 17, 33, 1 17- 
122, 186 189. 
Esthonia, syphiloid of, 133. 
Europe, epidemics of syphilis over, 116-119. 
Europe, syphilis in, 5. 

Eustachian catheterization, epidemics of 
syphilis from, 1 21 -1 23. 
how its dangers were first known, 

201. 
infection with syphilis by, 20, 

27, 32, 192, 193. 
location of primary syphilitic 
lesion, 192, 193. 
Examination of the men instead of the 

women, 206, 207. 
Examinations, syphilis communicated in, 

177, 178. 
Extra-genital chancres, clinical appear- 
ances of, 35. 
difficulty in recognition of, 108. 
relative frequency and statistics 

of, 24-29. 
frequency of occurrence in 2,000 

personal cases of syphilis, 36. 
general considerations, 24. 
location of, 24, 25, 29-35, 37- 
true percentage of, 26. 
personal cases, clinical consider- 
ations, 35, 36. 
relative proportion in private and 
public practice, 36. 
Eye diseases, syphilis communicated in the 
treatment of, 182, 183. 



Eyelid, chancre of the, 25, 30. 

personal cases, 37, 95-97. 

removed for epithelioma, 96, 97. 

acquired during parturition, 170. 

from application of the tongue, 
182, 183. 

from contact during sleep, in an 
infant, 170. 

from coughing in the face, 176. 

from a glove, 148. 

from handkerchief, 149. 

from incision of a stye, 192. 

from kissing, 151, 168. 

from mother's and also nurse's 
infected fingers, in an infant, 
169. 

from opera glass, 149, 150. 

from a towel, 96, 148. 

from wash- water, 193. 

from washing clothes, 156. 
Eyelids and conjunctiva, chancre of the, 

methods of acquiring and relative 
frequency of chancre of, 31, 32. 

Facaldina, 6, 17, 129. 
Face, chancres of the, causes of infec- 
tion in. 33. 
Facial contact, infection by, 176. 
Farther India, syphilis in, 8. 
Faymoreau, epidemic from glass-blowing 

at ? 120. 
Feeding-bottles, infection from, 165. 
Females, relative frequency of genital and 

extra -genital chancres in, 26-28. 
Feu de volupte', 8. 

Finger, as medium of conveying the virus 
of syphilis, 168, 169. 

chancre of, personal cases, 37, 

73-84. 
from assorting rags, 156. 
from a bite, 151. 
from craniotomy, 175. 
from drawing instrument, 1 50. 
from dressing a chancre, 152. 
from infected clothing, 81, 82. 
from manipulative procedure, 174. 
from operation upon piles, 194. 
from soiled linen, 156. 
from wound by bone of cadaver, 

173. 

in adults, 168. 
in a barber, 152. 
in a dentist, 175. 
in midwives, 27, 168, 177, 178. 
in a nurse, 168. 
in physicians, 74-81, 109, 173. 
Fingers, chancre between, at site of scabies 
lesion, 194. 

and hand, chancres of the, 25, 30. 



INDEX 



39 1 



Fingers, chancre of, occupations favoring, 

and relative frequency of, 31. 
Finnland, epidemics of syphilis in, 119, 

121, 122. 

prevalence of syphilis in, 140, 141. 
First epidemic of syphilis on record, 113, 

.114- 
Fmme, epidemic from vaccination at, 121. 
Flute, infection from a, 154 
Foot, chancre of, from shoe peg, 148. 
Forearm, chancre of the, 30, 151, 171. 

personal cases, 37, 104, 105. 
Forehead, chancre of the, 25. 

from incison of a furuncle, 191. 
Forehead and tempie, chancre of the, 30. 

relative frequency of, 33. 
Forks, infection from use of, 18, 143, 144. 
Forms of syphilis, 13. 

endemica, 17, 124-137. 
Fort Smith, epidemic from vaccination at, 

120. 
Fournier, non-venereal syphilis in females 

in private practice of, 27, 28. 
Frarnbcesia, 17, 134, 135. 
France, epidemics of syphilis in, 1 16-122. 
syphilis in, 3, 6. 

Belgium and colonies, statistics of 
extra-genital chancres, 30. 
Fredricksborg, epidemic from vaccination 

at, 118. 
Frenga, 6, 17, 131. 
Frequency of syphilis in the United States, 

200. 
Frienlels, epidemic from vaccination at, 

118. 
Furriers' syphilis, 18. 
Furuncle, infection from incision of, 191. 

General considerations in regard to 
syphilis, I. 
Germany, epidemics of syphilis in, 115. 

Switzerland and Holland, statis- 
tics of extra-genital chancres 
from, 30. 
Generation, effect of syphilis upon, 198. 
Glassblowers' syphilis, 18, 29, 154. 
Glassblowing, epidemics of syphilis from, 

120-122, 154. 
Glasses, drinking, infection from use of, 18, 

143-146, 166. 
Glove, infection from a, 148. 
Granos syphilis in Honduras, 11. 
Gratz, epidemic from tattooing at, 119. 
Great Britain and Ireland, syphilis in, 7, S. 
Great Britain, Ireland and colonies, sta- 
tistics of extra-genital chancres from, 30 
Greece, syphilis in, 6. 

'and, syphilis in. 1 1. 
Greenville, epidemic from vaccination at, 
I20. 



Groningen, epidemic from breast-drawing 

at, 117. 
Grosse Verole, 114. 
Grumello, epidemic from vaccination at, 

118. 
Guillotine, infection by cutting cigar in, 

147. 
Gum, chancre of the, 30, 190. 

Hakola, epidemic from cupping at, 119. 
Hand, chancre of the, personal cases, 

37, 99- 
from handling cast-off clothing, 

156. 
from a plaster, 148. 
from tooth wound, 99, 100, 151, 

152. 

Hand feeding of infants, epidemics of 
syphilis from, 19, 116, 120. 

Handkerchiefs, infection from, 18, 149. 

Hat, infection from a, 148. » 

Hawaiian Islands, syphilis in the, 12, 199. 

Hereditary syphilis, cases, effects, evils, 
and mortality of, 15, 17, 22, 27, 197-199. 

Herpes, virus of syphilis gaining entrance 
at site of, 21. 

Hesse, syphiloid of, 133. 

Hindostan, syphilis in, 9. 

Hip, chancre of, from contact in bed, 153. 

Holland, epidemics of syphilis in, 116, 1 1 7. 
syphilis in, 4. 

Honduras, syphilis in ; Granos, II. 

Hong Kong, syphilis in, 8. 

Hotel proprietor, his duty toward con- 
tagious diseases, 206. 

Housemaids' syphilis, iS, 155- 

Hungary, epidemics of syphilis in, 116, 120. 

Hygiene, in the prophylaxis of syphilis, 
200, 201. 

Iceland, syphilis in, 5. 
Implements and utensils, infection 
from, 143-146. 
India, syphilis in, 9. 

Indian tribes, effect of syphilis upon, 199. 
Indians, American, syphilis among the, 1 1. 
Individual prophylaxis, 200-202. 
Industrial transmission of syphilis, 18, 153- 

158. 
Infancy, accidental infection in, 27. 
Infants with acquired syphilis, methods of 

infection of 160. 
Infection by attendance on syphilitic in- 
fants, 166-171. 
by cephalic (buccal or facial) COn- 

ta< t. 170. 
by direct contact, 167-169, 177- 

183. 
by eating and drinking, 143-146. 
by hand feeding, 165, [66. 



39 2 



INDEX 



Infection by nutrition of infants, 158-165. 
by one woman, of 300 men, 204. 
auto-, by own act, 18. 
hetero-, by another's act, 18. 
immediate and mediate, definition, 
etc., of, 22, 23. 
Inflating lungs of new-born, syphilis 

caused by, 20, 76. 
Inguinal region, chancre of, from contact 

in bed, 169. 
Inherited syphilis, 15, 17. 

absence of initial lesion in, 22. 
from father alone, 23. 
Initial lesion, appearance and characters of, 

22. 
Innocent syphilL 5, 195. 

relative frequency of and per- 
centages in males and females, 
27-29. 
Innsbruck, statistics from Dr. Lang's clinic 

in, 25. 
Instrumental contact, infection by, 183- 

185. 
Intentional professional wounds, infection 

by, 191, 192. 
Ireland, epidemic from breast-drawing in, 

116. 
Italy, epidemics of syphilis in, 116-122. 

statistics of extra-genital chancres 

from, 30. 
syphilis in, 2, 6. 

spread by the invasion of by 
Charles VIII., 2, 114. 

Japan, syphilis in, 8. 
Japanese literature of syphilis, 3. 
Jaw, chancre of, personal case, 93, 94. 
Jugs, infection from, 18, 143. 
Jutish Peninsula, syphilis in the, 7. 
Jutland, syphiloid of, 133, 134. 

Kartoum, syphilis in, 10. 
Kasan, extra-genital syphilis in, 141. 
Kissing, as a cause of syphilis, 18, 19, 23, 

150, 151, 168. 

chancre of the lip from, 41-44, 
46, 49, 50, 52, 53, 62, 150, 

151, 168. 
Klein-russland, syphiloid of, 133, 134. 
Knives, infection from, 18, 143, 144. 
Konigsberg, epidemic from Eustachian 

catheterization at, 122. 
Krakau, epidemics from circumcision at, 
117, 118. 



L 



abrador, syphilis in, 11. 

Lactation, epidemics of syphilis from, 
116, 117, 119-121, 161-165. 
syphilis communicated by, 19, 
158-165. 



Laundresses, syphilis in, 18, 156. 

Law for controlling the spread of syphilis, 

206, 207. 
Lebus, epidemic from vaccination at, 122. 
Leech-bites, a medium of syphilitic trans- 
mission, 20. 
Leeds, epidemic from breast-drawing at, 

116. 
Leg, chancre of, from an electric brush, 193. 

from sucking a wound, 179. 
Leg and thigh, chancre of, 30. 
Legal control of syphilis, 202-207. 

responsibility in communicating 
syphilis, 207. 
Lepra Siberica, an endemic syphilis of 

Siberia, 137. 
Lepre Kabyle, 9, 10, 17, 132, 133. 
Leprosy, mistaken for syphilis, 112. 

relation to Radesyge, 127. 
Lips, chancres of, 25, 30, 37, 39-62. 

personal cases, 37, 39-62. 

relative frequency, 31, 39. 

sex of patients with, 39. 

from artificial flower making, 155. 

from assayer's blowpipe, 154. 

from a bassoon, 154. 

from a bite, 152. 

from a bugle, 154. 

from cigarette smoking, 55, 56. 

from cigars, 45, 54, 58-60, 146. 

from coins, 155, 156. 

from common use of cup, 45, 46. 

from dental instruments, 190. 

from drinking vessels, 144, 145. 

from feeding-bottle, 165. 

from infected finger, 168, 169. 

from furrier's thread, 155. 

from gum paste, 155. 

from kissing, 41-44, 46, 49, 50, 
52, 53, 62, 150, 151, 168. 

from lead pencil, 57, 58. 

from paper cutter, used as tongue 
depressor, 174. 

from pen held in mouth, 174. 

from a spoon, 144. 

from upholsterers' tacks, 155. 
Liquid substances, the medium of syphilitic 

infection, 186-189. 
Lint, infection from, 148, 180, 193. 
Lithuania, syphiloid of, 133. 

syphilis in, 7. 
Location of extra-genital chancres, 24, 25, 

29-35- 

personal cases, 37. 
Lombardy, epidemics from vaccination in, 

117, 118, 120. 
London, epidemic from circumcision at, 1 22. 
from tattooing, 123. 
from vaccination, 120, 122. 
Lourcine Hopital, statistics from, 25. 



INDEX 



393 



LumDar region, chancre of, from contact in 

bed, 153. 
Lungs, syphilis from inflating, 20, 176. 
Lupara, epidemic from vaccination at, 1 19. 
Luxeuil, epidemic from vaccination near, 
, 118. 

Madagascar, syphilis in, 10. 
Mai Anglais, or disease of St. Paul's 

Bay, 11, 128. 
Francais, 114, 132. 
Kabyle, 9, 10, 17, 132, 133. 
Napolitain, identity with Mai 

Kabyle, Syphilis, and Mai 

Francais, 132. 
Portugias, 8. 
de Brunn, epidemic of, 7, 115, 

184. 
de Chavanne-Lure, epidemic of, 

118, 144, 145. 
de Chicot, 128. 

de Fiume, or Scherljevo, 129, 130. 
de Naples, 114, 132. 
de Saint Euphemie, epidemic of, 

116. 
des Espagnols, 114. 
des Ottawas, 11. 
di Breno, 6, 17, 131. 
di Scarlievo, or Scherljevo, 129, 

130. 
Maladie de Berreshof, an endemic disease 

in Siberia, 137. 
de Ditmarsh, description of, 128, 

I2 9- 
d'Egersund, identity with Rade- 

syge, 126. 
Malay Archipelago, syphilis in, 8, 9, 127. 
Manual contact, infection from, 174. 
Marcalle, epidemic from lactation at, 120. 
Marital syphilis, or syphilis e coitu legit- 

ima, 15-17. 
its relation to syphilis insontium, 

196. 197. 
Marseilles, syphilis in, 6. 
Marsh disease, 7. 

Krankheit, or Morbus Dithmaren- 

sis, 128. 
Marsksygdom, or Morbus Dithmarensis, 

128, 129. 
Mask, infection from a, 148. 
Medical attendants, infected in their calling, 

20, 174, 175. 
Medico-legal aspect of venereal diseases, 

203. 
considerations, in syphilis in- 
sontium, 196-198. 
Men, examination of, 206, 207. 
Mercantile Marine, syphilis in the, 199, 200. 
Methods of the spread of syphilis, 107-1 10. 
Mexico, syphilis in, II. 



Middle German States, syphilis in, 7. 
Middlebourg epidemic from breast-draw- 
ing at, 116. 
Midi, Hopital du, statistics from, 25. 
Midwives, infection of, 27, 174, 175. 

syphilis conveyed by, 177, 178. 
Milan, epidemic from breast-drawing near, 

120. 
Milk, infection through the, 19, 23, 164. 
Minor surgery, infection by, 20, 191, 192. 
Modes of diffusion of syphilis, 113, 114. 

of infection of syphilis, classifica- 
tion. of the, 17-21. 
in syphilis brephotrophica, 19. 
economica, 18. 
epidemica, 17. 

insontium sine coitu, 21-23, ll1 ' 
technica, 20. 
Mohammedans, syphilis among the, 9. 
Molucca Islands, syphilis in the, 12. 
Money, infection by means of, 155, 156. 
Montecatini di val di Nievole, epidemic 

from lactation at, 121. 
Montlugon, epidemic from glass-blowing 

at, 121. 
Montmorenci, epidemic from lactation at, 

116. 
Morbus Dithmarensis, contagiousness, 
modes of transmission, etc., 17, 
128, 129. 
Gallicus, 114. 
Morocco, syphilis in, 9. 
Mortality in hereditary syphilis, 197, 198. 
Morula, description, nature, symptoms, 

treatment, etc., 17, 132. 
Mouth, chancre of, from dental work, 190. 
from handkerchief, 149. 
from lactation, 179. 
from raising uvula with finger, 177. 
from speaking-tube, 155. 
from tobacco pipe, 146. 
from tooth brush, 149. 
personal case, 43, 44. 
Mucous patches, most prolific source of 

syphilitic contagion, 23, 109. 
Musical instruments, infection from, 154. 
Musicians' syphilis, 18, 154, 155. 

Napkins, infection from, 167. 
Naples, epidemic from vaccination, 
at, I 19. 
Nates, chancre of, from anal examination, 

177. 
Neck, chancre of the, 25, 30. 
from a bite, 151. 
from carrying a woman, 153. 
from COn tad W it li infant, 168, I 7 I - 
from court plaster, [03, [0 |, 1 im- 
personal case, simulating sarcoma, 
37, 103, 104. 



394 



INDEX 



Netherlands, syphilis in the, 6. 

New Orleans, syphilitic bones exhumed in, 

II. 
New York City, accommodations for syph- 

ilitics in, 204. 

number of syphilitics treated in 
one year, 200. 
Nipple as conveyer of syphilitic virus, 19, 
164, 165. 

chancre of, from kissing, 151. 

from lactation, 160, 161. 

personal cases, 84-87. 
Non-reciprocal kissing, infection from, 

150, 151. 
Non-venereal syphilis, divisions of, 15, 17. 

in Founder's private practice, 27. 

personal cases, 35-107. 
North America, syphilis in, 11. 
Norway, epidemic of syphilis in, 118. 

and Sweden, syphilis in, 5. 
Nose, chancre of the, 25, 30. 

from infected ringer, 152. 

from tooth wound, 152. 

infected during parturition, 170. 

personal case, 37, 100, 101. 

relative frequency, 33. 
Nubia, syphilis in, 10. 
Nuremberg, epidemic from cupping at, 

115- 
Nurses infected by lactation, 159-163. 

by syphilitic nurslings, 19, 23, 27, 
161. 
Nursing, the chief mode of infection in 

Radesyge, 126. 
Nursing-bottles, infection from, 19, 165. 
Nurslings infected by nurses, 19, 23, 163, 

164. 
Nutrition of infants, infection through, 
158-165. 

Obstetrics, syphilis acquired in, 20, 174, 
175, 177, 178. 
Occupation, influence of, in production of 

syphilis, 28. 
Opera glasses, infection from, 18, 149, 150. 
Operations, syphilis acquired in, 20, 173, 

191, 192. 
Operator, infection of, 20, 1 72-176. 
by, 20, 176-196. 

Palate, chancre of, from blowpipe, 154. 
infection by lifting with finger, 20. 
Pandemic syphilis, definition, etc., of, no, 

in, 113. 
Pap, infection from, 165, 166. 
Parangi, 17, 136. 

Parasites, transmission of syphilis by, 194. 
Paris, epidemic from accouchement at, 116. 
from Eustachian catheterization 
at, 121. 



Paris, number of syphilitic beds in hos- 
pitals of, 204. 
police inspection in, 203. 
syphilis in, 6. 
Parturition, infection of infants during, 

169, 170. 
Passive contact, infection by, 153. 
Paste or lip gum, infection from, 155. 
Pastille, infection from a, 147. 
Pencils, infection from, 57, 155. 
Pens, infection from, 155. 
Percentage of extra-genital chancres, ac- 
cording to location, 31-34. 
in 2000 personal cases, 36. 
of syphilis in the United States, 
200. 
Peri-genital chancres, 30. 
Per partura, infection of infant, 19, 169, 170. 
Persia, syphilis in, 9. 
Personal cases of extra-genital chancres, 

35-I07- 
Personal and household effects, infection 

from, 147-150. 
Philadelphia, epidemic from tattooing at, 

122. 
Phlebotomy, transmission of syphilis by, 

20, 30, 115, 191. 
Phymosis, infection by operation for, 191. 
Physicians and surgeons infected in manip- 
ulative procedures, 174, 175. 
Pian, 10, 17, 134-136. 

de Nerac, epidemic from lacta- 
tion, known as, 116, 161, 162. 
Piles, infection upon finger during opera- 
tion for, 194. 
Pillows, infection from, 148. 
Pinching, infection from, 18, 152, 153. 
Pins, infection from, 18, %%, 89, 150. 
Plan for the legal control of syphilis, 205- 

207. 
Plaster, infection from, 103, 104, 148. 
Pocken amboyneuse, description of, 127. 
Poland, epidemics from circumcision in, 

117, 118. 
Porte-caustiques, as conveyers of syphilitic 

virus, 20, 193. 
Portugal, the amount of syphilis in, 204. 
Premezzo and Castellanza, epidemic from 

hand-feeding at, 120, 166. 
Primary lesions, location of, 25, 29, 30. 
Professional infection, general considera- 
tions, etc., 172-174. 
Prophylaxis of syphilis, 196, 197, 200, 201. 
Prostitution as a cause of syphilis, 4, 198, 
202. 

effect of examining the men upon 

clandestine, 206. 
its bearing upon the matter of 
legal protection against syphilis, 
202. 



INDEX 



395 



Prussia, epidemics of syphilis in, 117, 118, 
122 
syphilis in, 7. 
Psylle, as a syphilifer, 20, 179. 
Purpura, mistaken for syphilis, 1 12. 

Radesyge, 5, 17, 126, 127. 
Ragpickers' syphilis, 18. 
Rags, infection from, 156. 
Rape, innocent, syphilis caused by, 27. 
Razor wounds, infection in, 20, 190, 191. 
Reciprocal kissing, infection by, 150, 151. 
Republican ideas in United States, effect 

upon sanitary police inspection, 204. 
Riga Hospital, statistics from the, 25. 
Rivalta, epidemic from vaccination at, 119. 
Rive tie Gier, epidemics from glass-blowing 

at, 120, 154. 
Rochechonart, epidemic from accouche- 
ment at, 119. 
Roumania, syphilis in, 6. 
Rovello, epidemic from lactation at, 120. 
Rufino, epidemic from vaccination at, 119. 
Russia, epidemics of syphilis in, 123. 

prevalence of syphilis in, 140, 141. 
spread of syphilis in, 204. 
syphilis in, 4, 5. 

Poland and Asia, statistics of ex- 
tra-genital chancre from, 30. 

Sacral region, chancre of the, personal 
case, 37. 147. 

Sahara, syphilis in, 10. 

Sailors, syphilis, spread by, 4, 199, 200. 

Saint Euphemie, epidemic from accouche- 
ment at, 1 16, 177. 

Saint Lazare Hopital, statistics from, 25, 
203. 

Saint Maria Nuova, R. Arcesped. d., of 
Florence, statistics from, 25. 

Saliva, as a conveyer of syphilitic virus, 
20, 23. 

Scabies, masking the lesions of syphilis, 
1 12, 194. 

Scalp, chancre of, acquired during parturi- 
tion, 170. 
from comb, 149. 

Scherljevo, 6, 17, T29-131. 

Schleinitz and Saint Veit, epidemic from 
vaccination at, [21. 

Schleswick, epidemic from sheltering way- 
farers in, 1 [8. 

Schleswig Holstein, syphilis in, 7. 

Scinde Boil or Aleppo Evil, 17, 136. 

Scotland, syphilis in, 7. 

Scratching, infection from, t8, 152. 

Scrofula, its relation to syphilis, 140. 

Scrotum, chancre of, from scarification, 191. 

Seeland, syphilis in, 6. 

Semen, syphilis transmitted by, 23, 24. 



Senegal, syphilis in, 10. 
Serres-fines, a medium of syphilitic trans- 
mission, 20, 193. 
Servia, syphilis in, 6. 
Sex of patients with extra-genital chancres, 

26, 28. 37. 
Shanghai, syphilis in, 8. 
Sheets, infection from, 148. 
Sheffield, epidemic from accouchement 

near, 122. 
Sheltering wayfarers, epidemics of syphilis 

from, 115, 118. 
Shoemakers' pegs, infection from, 155. 

syphilis, 18. 
Shoe peg, infection from, 148. 
Sibbens, 7, 17, 125, 126, 192. 
Siberia, syphilis in, 8. 
Sicily, epidemics of syphilis in, 118. 
Sick chairs, infection from, 18, 149. 
Sierra Leone, syphilis in, 10. 
Siewens or Sibbens, endemic syphilis of 

Scotland, 125. 
Silesia, epidemic from circumcision in, 117. 

syphilis in, 7. 
Singapore, syphilis at, 8. 
Sitka, syphilis at, 1 1. 
Sivvens or Sibbens, distribution of, 125. 
Skin-grafting, infection by, 20, 185, 186. 
Sleep, infection during, 18, 19, 152, 170. 
Society, the rights of, in the question of 

protection from syphilis, 207. 
Soldiers, syphilis spread by, 4, 199. 
Sommerach, epidemic from cupping at, 1 15. 
Sorrento, epidemic from hand-raising of 

a foundling at, 116. 
Soudan, syphilis in, 10. 
Sounds, infection by use of, 20, 193. 
South Africa, syphilis in, 10. 

America, syphilis in, 1 1. 
Carolina, epidemics from vaccina- 
tion in, 121. 
Spain and Portugal, syphilis in, 6. 

Portugal, Mexico, and Brazil, sta- 
tistics of extra-genital chancres 
from, 30. 
Speaking-tube, infection from, 155. 
Specula, syphilis transmitted by use of, 

20, 193. 
Spedalskhed, relation to Radesyge, 127. 
Spirocolon, 6, 17, 131, 132. 
Sponges, infection from, i<), 149, 167. 
Spoons, infection by use of, iS, 19, 143, 

144, 155, 165, 166. 
Sporadic Syphilis, definition and divisions 

of, in. 
Sprinklers, infection from, in weavers, 154. 

Spyrokolon or spirocolon, its identity with 

syphilis, 1 ; 1 . 
Statistics of American Dermatological As- 
sociation for 14 years, 200, 



39^ 



INDEX 



Statistics of extra-genital chancres from 
different countries, 25-34. 
in author's practice, 28, 35. 
of syphilitic births, 197, 198. 
Sterility, effect of syphilis in causing, 198. 
Stockholm, epidemic from breast-drawing 

at, ri6. 
Stye, chancre from incision of, 192. 
Submaxillary chancre, from contact with 

chancre of chin, 153. 
Sucking of wounds, infection from, 178, 179. 
Sugar teat, infection from, 165. 
Surgeons infected with syphilis, 20, 28, 173. 
Surgical dressings, a means of transmis- 
sion, 20, 148. 
Surgical operations, infection in, 191, 192. 
Surgical sounds, infection from, 193. 
Sweden, epidemics of syphilis in, 116. 
Switzerland, epidemics of syphilis in, 115. 

syphilis in, 7. 
Syphilifer, operator the, 176-195. 
Syphilis, allusions to in the Bible, 2. 
among the Mohammedans, 9. 
among sailors and soldiers, 4, 199. 
antiquity of, 2. 
as a venereal and non-venereal 

disease, 13, in. 
brephotrophica, 19, ill, 142,158. 
carelessness of patients with, 199. 
contracted by operating upon 

syphilitics, 177, 178. 
conveyed by the semen, 23, 24. 
definition of, 2, 3. 
demography of, 107, 108. 
differs from other infectious dis- 
eases, 108. 
diffusion by railways, rivers and 

canals, 3, 4. 
distribution of, 5, 108. 
domestic transmission of, 18. 
from eating and drinking imple- 
ments, 18 
e coitu legitima, or marital syph- 
ilis, 15-17, 197. 
economica, 8, III, 142. 
effects of race and climate upon, 

137. 

endemica, 17, no, in. 

epidemica, 17, 113. 

forms of, 13. 

ground upon which safety from 

rests, 201, 202. 
industrial transmission of, 18. 
in Abyssinia, 10. 
in Afghanistan, 9. 
in Africa, 9. 
in Alaska, II. 
in Alexandria, 9, IO. 
in Algiers, 9. 
in Amboyna, 12. 



Syphilis in the Antilles, n. 
in Arabia, 9. 
in Armenia, 9. 
in Asia, 8. 
in Asia Minor, 9. 
in Australasia and Oceanica, 12. 
in Austro- Hungary, 7. 
in Bavaria, 7. 

in Belgium and Holland, 6. 
in Beloochistan, 9. 
in Brazil, n. 
in British America, n. 
in Central Africa, 10. 
in China, 2, 8. 

in Communities and Cities, 3, 4. 
in Denmark, 7. 
in Eastern Africa, 10. 
in Egypt, 9, 10. 
in Esthonia, 133. 
in Europe, 5. 
in Farther India, 8. 
in France, 3, 6, 
in Great Britain and Ireland, 7. 
in Greece, 6. 
in Greenland, 1 1, 
in the Hawaiian Islands, 12. 
in Hindostan, 9. 
in Holland, 4. 
in Honduras, II. 
in Hong Kong, 8. 
in Iceland, 5. 
in India, 9 

in the Indian tribes, 1 1, 
in Italy, 2, 6. 
in Japan, 8. 

in Japanese literature, 3. 
in the Jutish Peninsula, 7. 
in Kartoum, 10. 
in Labrador, n. 
in Lithuania, 7, 133. 
in Madagascar, 10. 
in the Malay Archipelago, 8, 9. 
in Manufacturing centres, 4. 
in Marseilles, 6. 
in Mexico, 1 1 . 

in the Middle German States, 7. 
in the Molucca Islands, 12. 
in Morocco, 9. 
in the Netherlands, 6. 
in North America, 1 1. 
in Norway and Sweden, 5. 
in Nubia, 10. 
in Paris, 6. 
in Persia, 9. 
in Prussia, 7. 
in Roumania, 6. 
in Rural districts, 4. 
in Russia, 4, 5. 
in Sahara, 10. 
in Schleswig-Holstein, 7. 



INDEX 



397 



Syphilis in Scotland, 7. 
in Seeland, 6. 
in Senegal, 10. 
in Servia, 6. 
in Shanghai, 8. 
in Siberia, 8. 
in Sierra Leone, 10. 
in Silesia, 7. 
in Singapore, 8. 
in Sitka. 1 1. 
in Soudan, 10. 
in South Africa, 10. 
in South America, 11. 
in Spain and Portugal, 6. 
in Switzerland, 7. 
in Syria, 9. 
in Tien-tsin, 8. 
in Tunis, 9. 
in Turkey, 6. 
in the United States, 11. 
in Western Africa, 10. 
in Western Asia, 9. 
in the West Indies, 11. 
in Wurtemberg, 7. 
in Yokohama, 8. 
in Zanzibar, 10. 
ingenita, or inherited syphilis, 15, 

17, 197- 

innocentium (or insontium), 13, 
14, 17. 

insontium, general considera- 
tions, 5, 14, 15. 

insontium, modes by which it is 
spread, prophylaxis, etc., 140, 
141. 

insontium sine coitu, modes of 
infection, 21-23. 

insontium, total personal cases, 

37, Hi- 

later effects of. 198, 199. 

legal control of, 202, 207. 

modificata, identity with syph- 
iloid, 133, 134. 

pandemica, 17, 1 10, III, 1 13. 

pravorum, ore coitu illicita, 13, 17. 

prevalence of, in this country, 
199, 200. 

relations to commercial inter- 
course, 4. 

relation to prostitution, 4. 

relation to scrofula, 140. 

sine coitu, 15-17, III. 

sporadica, 18-20, III, 142, 1 58, 
172, 195. 

spread by wars, fairs, festivals, 
etc., 4. 

technica, definition, etc., of, 20, 
in, 142, 172. 
Syphilitic bones exhumed in France and 
New Orleans, 3, 1 1. 



Syphilization, so-called, syphilis commu- 
nicated by, 20, 189. 

Syphiloid, description, distribution, symp- 
toms, etc., of, 17, 133, 134. 

Syphiloids, their relation to syphilis, 192. 

Syria, syphilis in, 9. 

Syringes, infection from, 19, 20, 149, 167, 
193- 

Table I., proportion of extra-genital to 
genital chancres, 25. 

II. , cases of non-sexual syphilis 
in females in private practice 
(Fournier), 27. 
III., localisation of extra-genital 

chancres, 30. 
IV., personal cases of extragen- 
ital syphilis, 37. 
V., ages of patients with extra- 
genital chancres (personal 
cases), 38. 
VI., epidemics of syphilis, 115- 
123. 
Tacks, method of infection by, 155. 
Tattooing, epidemics of syphilis from, 119, 
122, 123, 184. 
relative frequency of chancres 

caused by, 33, 34. 
syphilis communicated by, 20, 29, 
30, 104, 183, 184. 
Tavastehus, epidemic from cupping at, 121. 
Tears, incapable of communicating syph- 
ilis, 23. 
Teeth, infection by transplantation of, 20, 
185. 
by wounds of, 15 1, 152. 
Temple, chancre of, 30, 37, 102, 103. 
Tennessee, epidemics from vaccination 

in, 120. 
Thread, infection from, 155. 
Throat, deep, oral and nasal, chancres of, 

3°' 32. 
lesions of, in Lustachian infection, 
192. 193. 
Thumb, chancre of, from carrying infant, 171. 
by manipulative procedure, 174. 
in mid wives, 1 78. 
personal cases, 79, 99, IOO. 
Tien-tsin, syphilis in, S. 
Time, period of, iu which danger of infec- 
tion is greatest, 109. 

Tobacco and tobacco pipes, infection by 

use of, [8, 1 1". 147. 

Toilet articles, infection from, 1 X, 1 |.8, 1 I ». 
Tonga, an endemic syphilis of New Zea- 
land, 12, [37. 
Tongue, application of to eye, as cai 

syphilis, 20, 1 

chancres of the, 25, 30. 
from dental instrument, I90. 



MAR 11 ou, 



398 



INDEX 



Tongue, from own infected finger in in- 
fancy, 169. 

from pins, 88, 150. 

from shoemakers' pegs, 155. 

from spoon, 144. 

from tobacco pipe, 146. 

personal cases, 37, 87-91. 

relative frequency, 32. 
Tongue spatula, as medium of trans- 
mission, 20. 
Tonsils, chancres of the, 30. 

from nursing-bottle, 165. ' 

from spoon, 144. 

modes of infection and relative 
frequency of, 32. 

personal cases, 37, 47, 62-73. 
Toothbrush, infection from, 149. 
Toothpick, infection from, 149. 
Tooth wounds, infection from, 15 1, 152. 
Topparla, epidemic from cupping at, 1 19. 
Torre del Buse, epidemic from vaccina- 
tion at, 120. 
Tourcoring, epidemic from breast-drawing 

at, 122. 
Towel, infection from a, 148. 
Transplantation of teeth, infection by, 20, 

185. 
Troches, infection by, 18, 147. 
Trunk, chancres of the, 30. 
Tunis, syphilis in, 9. 
Turkey, syphilis in, 6. 

Udine, epidemic from vaccination at, 117. 
Uleaborger, epidemic from cupping 
at, 119. 
Umbilicus, infection of new-born at, 20, 

178. 
Unclassified chancres, 25. 
Unclean instruments and substances, infec- 

ion from, 189 194. 
United States, epidemics of syphilis in, 
120-122. 

hospitals for syphilitics in, 204. 
statistics of extra-genital chancres 

from the, 30. 
syphilis in the, 1 1. 
Upholsters' syphilis, 18, 155. 
Urinals, infection from, 18, 149. 



V 



accination, epidemics of syphilis from, 
117-122, 186-188. 

infection from, 19, 20, 27, 30. 
relative frequency cf chancres by, 
33- 



Vaccination syphilis, how it differs from 
ordinary syphilis, 188, 189. 
how first observed, 201. 
Vagina, infection by exploration of, 20. 
Variolation, transmission of syphilis by- 
process of, 20, 189. 
Venereal clinics, statistics from, 25, 26. 

syphilis, reason of its frequency, 
109, no. 
Vienna, epidemic from circumcision at r 
121. 

statistics frcm the Allgem. K. K. 
Krankenhaus in, 25. 
Virus of syphilis, nature, etc., of, 2, 107, 

202, 203. 
Vulva, chancre of, from sponge, 149, 167. 

Washing, infection from, 156. 
Wash-water, infection from, 19, 
20, 167, 193. 
Water closets, infection from, 18, 149. 
Wearing apparel, infection from, 18, 147, 

148. 
Weavers, infection in, 18, 154. 
Western Africa, syphilis in, 10. 
Western Asia, syphilis in, 9. 
West Indies syphilis in the, 1 1. 
Wet-cupping, syphilis from, 184, 185. 
Wet-nurses, infection in, 27, 159. 
Whistle, infection from, 154, 155. 
Wilbedessen, epidemic from lactation at, 

117. 
Windsheim, epidemic from cupping at, 

"5- 

Wjatka Government, epidemic from ap- 
plication of tongue to eye in, 123. 

World, diffusion of syphilis throughout, 5. 
epidemics of syphilis over the 
whole, 119-123. 

Wounds, professional, infection in, 190- 
192. 

Wound sucking, infection from, 20, 176, 
178-180. 

Wurtemberg, syphilis in, 7. 

Yang-mey-tchoang, 17, 133. 
Yaws or Frambcesia, 7, IO, II, 17, 
I34-I36- 
Yokohama, syphilis in, 8. 

Zanzibar, syphilis in, 10. 
Zurich, epidemic from cupping and 
sheltering wayfarers at, 115. 



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